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http://dx.doi.org/10.7181/acfs.2021.00290

Anterior skull base reconstruction using an anterolateral thigh free flap  

Kim, Shin Hyun (Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine)
Lee, Won Jai (Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine)
Chang, Jong Hee (Department of Neurosurgery, Yonsei University College of Medicine)
Moon, Joo Hyung (Department of Neurosurgery, Yonsei University College of Medicine)
Kang, Seok Gu (Department of Neurosurgery, Yonsei University College of Medicine)
Kim, Chang Hoon (Department of Otorhinolaryngology, Yonsei University College of Medicine)
Hong, Jong Won (Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine)
Publication Information
Archives of Craniofacial Surgery / v.22, no.5, 2021 , pp. 232-238 More about this Journal
Abstract
Background: Galeal or temporalis muscle flaps have been traditionally used to reconstruct skull base defects after tumor removal. Unfortunately, these flaps do not provide sufficient vascularized tissue for a dural seal in extensive defects. This study describes the successful coverage of large skull base defects using anterolateral thigh (ALT) free flaps. Methods: This retrospective study included five patients who underwent skull base surgery between June 2018 and June 2021. Reconstruction was performed using an ALT free flap to cover defects that included the intracranial space and extended to the frontal sinus and cribriform plate. Results: There were no major complications, such as ascending infections or cerebrospinal leakage. Postoperative magnetic resonance imaging showed that the flaps were well-maintained in all patients. Conclusion: Successful reconstruction was performed using ALT free flaps for large anterior skull base defects. In conclusion, the ALT free flap is an effective option for preventing communication between the nasal cavity and the intracranial space.
Keywords
Free tissue flaps; Reconstructive surgery; Temporal artery;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Suh JM, Chung CH, Chang YJ. Head and neck reconstruction using free flaps: a 30-year medical record review. Arch Craniofac Surg 2021;22:38-44.   DOI
2 Amin A, Rifaat M, Civantos F, Weed D, Abu-Sedira M, Bassiouny M. Free anterolateral thigh flap for reconstruction of major craniofacial defects. J Reconstr Microsurg 2006;22:97-104.   DOI
3 Malata CM, Tehrani H, Kumiponjera D, Hardy DG, Moffat DA. Use of anterolateral thigh and lateral arm fasciocutaneous free flaps in lateral skull base reconstruction. Ann Plast Surg 2006;57:169-76.   DOI
4 Gil Z, Abergel A, Leider-Trejo L, Khafif A, Margalit N, Amir A, et al. A comprehensive algorithm for anterior skull base reconstruction after oncological resections. Skull Base 2007;17:25-37.   DOI
5 Chang DW, Langstein HN, Gupta A, De Monte F, Do KA, Wang X, et al. Reconstructive management of cranial base defects after tumor ablation. Plast Reconstr Surg 2001;107:1346-57.   DOI
6 Menderes A, Yilmaz M, Vayvada H, Demirdover C, Barutcu A. Reverse temporalis muscle flap for the reconstruction of orbital exenteration defects. Ann Plast Surg 2002;48:521-6.   DOI
7 Chung SW, Hong JW, Lee WJ, Kim YO. Extended temporalis flap for skull base reconstruction. Arch Craniofac Surg 2019;20:126-9.   DOI
8 Valentini V, Fabiani F, Nicolai G, Torroni A, Gennaro P, Marianetti TM, et al. Use of microvascular free flaps in the reconstruction of the anterior and middle skull base. J Craniofac Surg 2006;17:790-6.   DOI
9 Chang HP, Hong JW, Lee WJ, Kim YS, Koh YW, Kim SH, et al. Incorporating a continuous suction system as a preventive measure against fistula-related complications in head and neck reconstructive surgery. Arch Plast Surg 2018;45:449-57.   DOI
10 Hanasono MM, Silva A, Skoracki RJ, Gidley PW, DeMonte F, Hanna EY, et al. Skull base reconstruction: an updated approach. Plast Reconstr Surg 2011;128:675-86.   DOI
11 Schmalbach CE, Webb DE, Weitzel EK. Anterior skull base reconstruction: a review of current techniques. Curr Opin Otolaryngol Head Neck Surg 2010;18:238-43.   DOI
12 Langstein HN, Chang DW, Robb GL. Coverage of skull base defects. Clin Plast Surg 2001;28:375-87.   DOI
13 Gagliardi F, Boari N, Mortini P. Reconstruction techniques in skull base surgery. J Craniofac Surg 2011;22:1015-20.   DOI
14 Kim YW, Lee DH, Cheon YW. Secondary reconstruction of frontal sinus fracture. Arch Craniofac Surg 2016;17:103-10.   DOI
15 Kim YO, Park BY. Reverse temporalis muscle flap: treatment of large anterior cranial base defect with direct intracranial-nasopharyngeal communication. Plast Reconstr Surg 1995;96:576-84.   DOI
16 Neligan PC, Mulholland S, Irish J, Gullane PJ, Boyd JB, Gentili F, et al. Flap selection in cranial base reconstruction. Plast Reconstr Surg 1996;98:1159-68.   DOI
17 Cantu G, Solero CL, Pizzi N, Nardo L, Mattavelli F. Skull base reconstruction after anterior craniofacial resection. J Craniomaxillofac Surg 1999;27:228-34.   DOI
18 Shin D, Yang CE, Kim YO, Hong JW, Lee WJ, Lew DH, et al. Huge anterior skull base defect reconstruction on communicating between cranium and nasal cavity: combination flap of galeal flap and reverse temporalis flap. J Craniofac Surg 2020;31:436-9.   DOI
19 Gullane PJ, Lipa JE, Novak CB, Neligan PC. Reconstruction of skull base defects. Clin Plast Surg 2005;32:391-9.   DOI
20 Kwon SG, Kim YO, Rah DK. Anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft. Arch Plast Surg 2012;39:345-51.   DOI
21 Girod A, Boissonnet H, Jouffroy T, Rodriguez J. Latissimus dorsi free flap reconstruction of anterior skull base defects. J Craniomaxillofac Surg 2012;40:177-9.   DOI
22 Boyle JO, Shah KC, Shah JP. Craniofacial resection for malignant neoplasms of the skull base: an overview. J Surg Oncol 1998;69:275-84.   DOI
23 Noone MC, Osguthorpe JD, Patel S. Pericranial flap for closure of paramedian anterior skull base defects. Otolaryngol Head Neck Surg 2002;127:494-500.   DOI