Reconstructive myofascial skull-base flaps: normal appearance on CT and MR imaging studies

Area of Science:

• Radiology
• Head and Neck Surgery
• Plastic Surgery

Background:

• Reconstructive surgery often utilizes various flaps for skull base defects.
• Accurate identification of these flaps on imaging is critical for patient management.
• Misinterpretation can lead to incorrect diagnoses and treatment plans.

Purpose of the Study:

• To describe the characteristic imaging features of common flaps used in anterior skull base reconstruction.
• To differentiate between normal flap appearance and potential pathology such as tumor recurrence.

Main Methods:

• Review of imaging studies (CT, MRI) of patients who underwent skull base reconstruction.
• Analysis of the morphological and enhancement patterns of temporalis myofascial, free, and pericranial flaps.
• Correlation of imaging findings with surgical and pathological data.

Main Results:

• Temporalis myofascial flaps show tendon and fractured coronoid process on imaging.
• Free flaps with microvascular anastomosis appear as large, bulky muscle with subcutaneous fat.
• Pericranial flaps are thin, curvilinear, and enhance, bridging osseous defects.

Conclusions:

• Familiarity with specific flap imaging features aids in accurate diagnosis.
• Distinguishing normal flaps from tumors prevents misdiagnosis and ensures timely detection of recurrence.