Free perforator flap transfer for reconstruction of skull base defects after resection of advanced recurrent tumor

Background Skull base reconstruction is challenging due to its proximity to important anatomical structures. This report evaluates the use of perforator flaps for reconstruction of skull base defects after advanced recurrent tumor resection. Methods Fourteen free perforator flaps were transferred to...

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Bibliographic Details
Published in:Microsurgery 2014-11, Vol.34 (8), p.623-628
Main Authors: Zhang, Bin, Wan, Jing-Hai, Wan, Han-Feng, Li, De-Zhi, Zhang, Yong-Xia
Format: Article
Language:English
Subjects:
Adult
Aged
Carcinoma - pathology
Carcinoma - surgery
Female
Free Tissue Flaps
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - surgery
Humans
Male
Middle Aged
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - surgery
Neoplasms, Squamous Cell - pathology
Neoplasms, Squamous Cell - surgery
Perforator Flap
Reconstructive Surgical Procedures
Retrospective Studies
Sarcoma - pathology
Sarcoma - surgery
Skull Base Neoplasms - pathology
Skull Base Neoplasms - surgery
Treatment Outcome
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Summary:Background Skull base reconstruction is challenging due to its proximity to important anatomical structures. This report evaluates the use of perforator flaps for reconstruction of skull base defects after advanced recurrent tumor resection. Methods Fourteen free perforator flaps were transferred to reconstruct skull base defects in 14 consecutive patients, from October 2004 to May 2011. All patients had advanced recurrent neoplasms that were previously treated with either radiation therapy or surgery. The surgical defects were reconstructed using various perforator flaps mainly the deep inferior epigastric artery perforator flaps, anterolateral thigh (ALT) flaps, or thoracodorsal artery perforator flaps. The outcomes following reconstruction and associated complications were evaluated. Results The overall free flap success rate was 93% (13/14). One ALT flap was lost. Three patients (20%) had a cerebrospinal fluid fistula, and two of them developed meningitis. No complications were observed at the donor site. Conclusions The use of perforator flaps may be a viable option for reconstruction of skull base defects after the resection of advanced recurrent tumor. © 2014 Wiley Periodicals, Inc. Microsurgery 34:623–628, 2014.
ISSN:0738-1085
1098-2752
DOI:10.1002/micr.22271