Free tissue transfer for skull base reconstruction of advanced oncological defects
Zhang, B.; Wan, J.-h.; Zhang, Y.-x.; An, C.-m.; Xu, Z.-g.; Tang, P.-z.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 45(5): 406-409
2010
ISSN/ISBN: 1673-0860 PMID: 20654178 Document Number: 647834
To analyze the results and the indications of free flaps in the skull base reconstruction. A retrospective review was performed of 25 free flaps reconstructions for skull base tumor ablation defects between March of 1999 and March of 2009. There were 9 latissimus dorsi flaps, 6 rectus abdominis flaps, 4 deep inferior epigastric artery perforator flaps, 3 anterolateral thigh flaps, 2 radial forearm flaps and 1 fibular flap. The defects were classified as cranial bone (100%), dura (40%), brain (12%), sino-nasal cavity (52%), mucosa (56%) and skin (80%). Twenty-three of 25(92%) free flaps survived. One total flap failure and 1 partial flap failure occurred. Five patients (20%) had central nervous system related postoperative complications which including 1 mortality, 2 central nerve system infection and 2 cerebrospinal fluid fistula. Free flaps transfer is a reliable reconstruction technique for cranial base surgery. This provides a solution to the select advances disease otherwise surgical contraindications. Free flap is the choice for reconstruction of advanced oncological defects, especially when skin and mucosa are violated.