Microvascular Free Tissue Transfer for Reconstruction of Anterior Skull Base Defects.
Thomas Townes1, Edward I Chang2, Matheus Sewastjanow-Silva1
1Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Head & Neck
|November 17, 2025
Summary
Free flap reconstruction effectively repairs anterior skull base defects after tumor removal. Chimeric anterolateral thigh flaps offer versatile solutions for complex cases, demonstrating good outcomes.
Area of Science:
- Plastic Surgery
- Oncologic Reconstruction
- Skull Base Surgery
Background:
- Focuses on free flap reconstruction for anterior skull base (SB) defects.
- Addresses complex composite defects in patients with SB tumors undergoing multimodality therapy.
Purpose of the Study:
- To evaluate outcomes of free flap reconstruction for anterior SB defects.
- To highlight the utility of chimeric flaps in complex SB reconstructions.
Main Methods:
- Retrospective analysis of patients undergoing anterior SB free flap reconstruction.
- Review of ablative approaches and reconstructive techniques used.
Main Results:
- Sixty-three anterior SB free flap reconstructions were performed.
- Anterolateral thigh (ALT) flaps, particularly chimeric ALT flaps, were the most common reconstructive method.
- Complications occurred in 33% of patients within 30 days; no surgical mortality was reported.
Conclusions:
- Microvascular free tissue transfer is an effective reconstructive option for the anterior SB.
- Chimeric free flaps are advantageous for anterior SB reconstruction due to their inset flexibility and ability to manage adjacent areas without excess bulk.
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