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J Neurol Surg B Skull Base 2013; 74(05): 324-330
DOI: 10.1055/s-0033-1353364
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Outcomes following Microvascular Free Tissue Transfer in Reconstructing Skull Base Defects

Jose L. Llorente
1   Department of Otorhinolaryngology, Skull Base Unit, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Fernando Lopez
1   Department of Otorhinolaryngology, Skull Base Unit, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Daniel Camporro
2   Department of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Angel Fueyo
2   Department of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Juan C. Rial
3   Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Ramon Fernandez de Leon
3   Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Carlos Suarez
1   Department of Otorhinolaryngology, Skull Base Unit, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
› Author Affiliations
Further Information

Publication History

16 January 2013

15 June 2013

Publication Date:
14 August 2013 (online)

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Abstract

Objective Successful resection of complex tumors involving the skull base (SB) depends on the ability to reconstruct the resulting defects. The objective of this study was to assess the outcomes of patients undergoing reconstruction after resection of SB tumors with free flaps.

Methods From 1995 to 2010 a retrospective review of cases was undertaken. Demographics, histology, surgical management, complications, locoregional control, and survival were analyzed.

Results We performed 62 flaps in 57 patients. There was a preponderance of sinonasal malignancies (45%), and most lesions involved the anterior SB (81%). A total of 94% of patients underwent radiotherapy. Reconstruction was undertaken mainly with anterolateral thigh (37%) or radial forearm (34%) flaps. Complications occurred in 17% of patients, and the flap's success rate was 94%.

Conclusion Free flaps are versatile and highly reliable for reconstructing defects resulting from resections of the SB. They should be considered for SB reconstruction of large three-dimensional defects as well as defects involving an irradiated field. Successful reconstruction of the SB can be performed using a small number of highly dependable flaps.

Keywords

skull base - head and neck reconstruction - skull base defects - free flaps - microvascular free tissue transfer
 

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