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Updated: Jul 18, 2026
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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Reconstruction of complicated skull base defects utilizing free tissue transfer
Summary
Microvascular free tissue transfer effectively treats complex skull base defects and infections. This method successfully resolved cerebrospinal fluid leaks and meningitis in five patients when other treatments failed.
Area of Science:
- Neurosurgery
- Plastic Surgery
- Infectious Disease
Background:
- Large skull base defects pose significant challenges, often complicated by persistent infections, cerebrospinal fluid (CSF) leaks, and meningitis.
- Conventional treatments, including fat grafts and regional flaps, frequently fail to adequately address these complex post-surgical or trauma-related defects.
Observation:
- Five patients with large skull base defects, complicated by severe infections, CSF leaks, and/or meningitis, were treated.
- All patients had previously failed conservative management and reconstructive attempts with less robust tissue options.
Findings:
- Microvascular free tissue transfer, utilizing rectus abdominis myofascial, radial forearm, or gracilis muscle flaps, was performed after thorough debridement of infected cavities.
- Successful control of CSF leaks, local infections, and meningitis was achieved within one week post-operatively in all five patients.
- The viable, well-vascularized tissue from free flaps provided both a mechanical seal and enhanced local infection clearance.
Implications:
- Microvascular free tissue transfer represents a highly effective reconstructive strategy for complex skull base defects with associated infections.
- This approach offers a reliable solution for managing refractory CSF leaks and meningitis, improving patient outcomes.
- The findings support the use of robust, vascularized tissue transfer in challenging craniofacial reconstructions.
