Outcomes following Microvascular Free Tissue Transfer in Reconstructing Skull Base Defects
Jose L Llorente1, Fernando Lopez1, Daniel Camporro2
1Department of Otorhinolaryngology, Skull Base Unit, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Journal of Neurological Surgery. Part B, Skull Base
|January 18, 2014
Summary
Free flaps are reliable for skull base (SB) reconstruction after tumor resection. This study shows a 94% flap success rate, making them ideal for complex SB defects, even in irradiated fields.
Area of Science:
- Reconstructive surgery
- Oncology
- Skull base surgery
Background:
- Successful skull base (SB) tumor resection requires effective defect reconstruction.
- Free flap reconstruction is a key technique for complex SB defects.
Purpose of the Study:
- To evaluate the outcomes of free flap reconstruction in patients following SB tumor resection.
- To assess the success rates and complications associated with free flaps in SB reconstruction.
Main Methods:
- Retrospective review of 57 patients undergoing 62 free flap reconstructions between 1995 and 2010.
- Analysis of demographics, tumor histology, surgical procedures, complications, locoregional control, and survival.
- Detailed assessment of flap types used, including anterolateral thigh and radial forearm flaps.
Main Results:
- The majority of tumors were sinonasal malignancies (45%) involving the anterior SB (81%).
- 94% of patients received radiotherapy.
- The overall flap success rate was 94%, with complications in 17% of patients. Anterolateral thigh (37%) and radial forearm (34%) flaps were most common.
Conclusions:
- Free flaps are versatile and highly reliable for SB defect reconstruction.
- They are recommended for large, three-dimensional, or irradiated SB defects.
- Effective SB reconstruction can be achieved with a limited number of dependable flap options.
