The versatile extended pericranial flap for closure of skull base defects
Presented at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, Orlando, FL, September 21-24, 2003
Abstract
Objective
We sought to demonstrate the technical aspects of the extended pericranial flap and its versatility in reconstruction of a variety of skull base defects.
Study design
We conducted a retrospective chart review of 32 patients who underwent reconstruction of skull-base defects with an extended pericranial flap by the senior author (Y.D.) from September 1997 to July 2003.
Methods
Patients with skull base defects after trauma or extirpative surgery were reconstructed with either a lateral- or an anterior-based vascularized extended pericranial flap. Variables and outcomes measured included: the size and anatomical location of the defect, need for other flaps, preoperative and/or postoperative radiation therapy and/or chemotherapy, bone flap necrosis, hardware exposure, wound dehiscence, postoperative cerebrospinal fluid (CSF) leak, and meningitis.
Results
There was no evidence of flap failure, 2 cases of transient (3 to 4 days) CSF leak without resultant meningitis, 3 patients with hardware exposure, and 2 patients with hydroxyapatite infection. The 2 transient cases of CSF leak both resolved without further surgical intervention or the placement of a lumbar drain.
Conclusion
Both the lateral and anteriorly based extended pericranial flaps are reliable and versatile flaps associated with minimal morbidity and a low rate of complications when used to reconstruct defects of the anterolateral skull base.
aDepartment of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
bDivision of Otolaryngology and Facial Plastic Surgery, John Peter Smith Hospital, Fort Worth, Texas, USA
Reprint requests: Y. Ducic, MD, Director, Otolaryngology and Facial Plastic Surgery, John Peter Smith Hospital, 1500 S Main St, Fort Worth, TX 76104, USA
ABSTRACT