Use of the Nasoseptal Flap is the standard method for reconstruction of skull base defects in endoscopic endonasal surgery. This video demonstrates how endoscopic ICG can be used to confirm that the nasoseptal flap is well vascularized in order to have a successful reconstruction of the cranial defect.  Studies have shown that the surgeon can assess if blood flow to the harvested flap is adequate or not to determine best way to provide the patient with a well perfused nasoseptal flap and reduce the incidence of CSF leaks and less  complications requiring a return to the operating room.