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Reconstruction for Skull Base Defect Using Fat-Containing Perifascial Areolar Tissue
Woo Young Choi1, Ki Wook Sung, Young Seok Kim
1From the *Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine, Gwangju; †Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, and ‡Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
Fat-containing perifascial areolar tissue (PAT) offers an effective method for reconstructing limited skull base defects and augmenting volume. This technique demonstrated no significant complications and minimal donor site morbidity in a small patient cohort.
Area of Science:
- Plastic Surgery
- Craniofacial Reconstruction
- Tissue Engineering
Background:
- Skull base reconstruction presents significant challenges due to anatomical complexity and defect size.
- Limited defect reconstruction often requires specialized techniques for optimal outcomes.
- Volume augmentation in craniofacial areas necessitates reliable and accessible autologous tissue sources.
Observation:
- Fat-containing perifascial areolar tissue (PAT) was harvested from the inguinal region for skull base reconstruction and forehead volume augmentation.
- Five patients underwent reconstruction using PAT for defects resulting from tumor resection or trauma.
- The harvested PAT exhibited a mean fat thickness of 5-9 mm and mean graft size of 65.6 cm³.
Findings:
- The study demonstrated the efficacy of fat-containing PAT in reconstructing limited skull base defects and for volume replacement.
- All patients achieved successful reconstruction with no notable complications or donor site morbidity.
- Postoperative follow-up, including MRI, confirmed the viability and integration of the grafted PAT.
Implications:
- Fat-containing PAT provides a viable and accessible autologous tissue option for specific skull base reconstructions and volume augmentation.
- This technique can be utilized independently or as an adjunct to other reconstructive methods like free or regional flaps.
- The findings suggest that PAT is a valuable addition to the armamentarium for addressing craniofacial defects.
