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Published on: March 1, 2015
The Vascularized Occipital Fascial Flap (OFF): A Novel Reconstructive Technique for Posterior Fossa Surgery
Pankaj K Agarwalla1, Ali Tayebi Meybodi1, Max Ward2
1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Background:
Posterior fossa surgery is particularly prone to cerebrospinal fluid (CSF) leakage. Several methods have been introduced to address and/or prevent this complication. However, to the best of our knowledge, the use of a vascularized fascial flap based on the occipital artery for the purpose of reconstruction has not been reported. We introduce the occipital fascial flap (OFF) for reconstruction of a craniectomy defect after the retrosigmoid approach.
Methods:
A 57-year-old woman with a large cerebellar metastasis underwent gross total resection of the mass followed by reconstruction of the craniectomy defect using OFF.
Results:
Postoperative imaging showed flap viability and no CSF leak occurred during follow-up.
Conclusions:
We report the first use of OFF for reconstruction of a craniectomy defect in a retrosigmoid approach. The vascularized fascial flap in posterior fossa surgery is a potentially helpful technique to reduce the risk of CSF leak in high-risk patients.
