Invited Discussion: Use of Anterolateral Thigh and Lateral Arm Fasciocutaneous Free Flaps in Lateral Skull Base Reconstruction

2006 ◽  
Vol 57 (2) ◽  
pp. 176
Author(s):  
Peter C. Neligan
Keyword(s):  
Skull Base ◽  
Free Flaps ◽  
Skull Base Reconstruction ◽  
Lateral Skull Base ◽  
Anterolateral Thigh

Use of Anterolateral Thigh and Lateral Arm Fasciocutaneous Free Flaps in Lateral Skull Base Reconstruction

2006 ◽  
Vol 57 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Charles M. Malata ◽  
Hamid Tehrani ◽  
Devor Kumiponjera ◽  
David G. Hardy ◽  
David A. Moffat
Keyword(s):  
Skull Base ◽  
Free Flaps ◽  
Skull Base Reconstruction ◽  
Lateral Skull Base ◽  
Anterolateral Thigh

scholarly journals Anterior skull base reconstruction using an anterolateral thigh free flap

2021 ◽  
Vol 22 (5) ◽  
pp. 232-238
Author(s):  
Shin Hyun Kim ◽  
Won Jai Lee ◽  
Jong Hee Chang ◽  
Joo Hyung Moon ◽  
Seok Gu Kang ◽  
...  
Keyword(s):  
Skull Base ◽  
Free Flap ◽  
Free Flaps ◽  
Anterior Skull Base ◽  
Temporalis Muscle ◽  
Muscle Flaps ◽  
Skull Base Reconstruction ◽  
Anterolateral Thigh ◽  
Effective Option ◽  
Skull Base Defects

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.

Endoscopic Insetting of Free Flaps in Skull Base Reconstruction

2020 ◽  
pp. 1-8
Author(s):  
Caroline Driessen ◽  
Erik J. Stigare ◽  
Andres Rodriguez Lorenzo
Keyword(s):  
Skull Base ◽  
Free Flaps ◽  
Skull Base Reconstruction

scholarly journals Stepwise Algorithm for Skull Base Reconstruction in Endoscopic Endonasal Surgery: From the Simple to the Complex

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Maria Belen Vega ◽  
Philippe Lavigne ◽  
Vanessa Hernandez-Hernandez ◽  
Aldo Eguiluz-Menendez ◽  
Eric Wang ◽  
...  
Keyword(s):  
Skull Base ◽  
Posterior Fossa ◽  
Free Flaps ◽  
Fat Graft ◽  
Csf Leak ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Skull Base Reconstruction ◽  
Skull Base Defects

Abstract INTRODUCTION The most frequent complication of endoscopic endonasal surgery (EES) is postoperative cerebrospinal fluid (CSF) leak. This study was designed to develop a step-wise algorithm for EES reconstruction across the spectrum of skull base defects: from free mucosal graft for uncomplicated pituitary adenomas to free flaps in complex cases with recurrent leaks. METHODS All patients with skull base pathologies who underwent EES between January 2017 and December 2018 were included and retrospectively analyzed. Tumor location, reconstruction method and postoperative CSF leak were reviewed and a step-wise algorithm based on size and location of defect was developed. RESULTS Location of skull base defects was categorized as follows: anterior fossa, suprasellar, sellar and posterior fossa. For all nonsellar sites, we performed a multilayer (collagen matrix + /- fascia lata + /− fat graft + vascularized flap) reconstruction. The nasoseptal flap (NSF) was the first choice for vascularized reconstruction when available. For all sellar lesions we employed a free mucosal graft unless a high-flow CSF leak was present, in which case a single-layer reconstruction with NSF was performed. When the NSF was not available, alternative local (lateral nasal wall flap) and regional (extracranial pericranial flap) pedicled flaps were successful choices. When patients failed multiple attempts at repair, regional or microvascular free flaps were options. Lumbar spinal drainage was employed for large anterior and posterior fossa defects and during secondary repair of postoperative CSF leaks. Of 347 patients, 4.6% had a postoperative CSF leak. Of 158 patients with an intraoperative leak (45.5%), 10.1% developed a postoperative CSF leak: 7.8% for sellar/suprasellar defects and 13% for anterior/posterior fossa defects. CONCLUSION This algorithm provides a standardized, stepwise approach to the reconstruction of all skull base defects after EES based on location.

The use of free flaps in skull base reconstruction

2016 ◽  
Vol 45 (2) ◽  
pp. 158-162 ◽  
Author(s):  
G. Macía ◽  
M. Picón ◽  
J. Nuñez ◽  
F. Almeida ◽  
I. Alvarez ◽  
...  
Keyword(s):  
Skull Base ◽  
Free Flaps ◽  
Skull Base Reconstruction

Composite Skull Base Reconstruction Using the Anterolateral Thigh Flap

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Matthew Hanasono ◽  
Roman Skoracki ◽  
Justin Sacks ◽  
Neha Goel ◽  
Martina Ayad ◽  
...  
Keyword(s):  
Skull Base ◽  
Anterolateral Thigh Flap ◽  
Skull Base Reconstruction ◽  
Anterolateral Thigh

Vascularised local and free flaps in anterior skull base reconstruction

2012 ◽  
Vol 270 (3) ◽  
pp. 899-907 ◽  
Author(s):  
Thomas K. Hoffmann ◽  
Nicolai El Hindy ◽  
Oliver M. Müller ◽  
Patrick J. Schuler ◽  
Christoph Bergmann ◽  
...  
Keyword(s):  
Skull Base ◽  
Free Flaps ◽  
Anterior Skull Base ◽  
Skull Base Reconstruction
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