Gullane Patrick J, Lipa Joan E, Novak Christine B, Neligan Peter C
Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Ontario, Canada.
Clin Plast Surg. 2005 Jul;32(3):391-9, vii. doi: 10.1016/j.cps.2005.02.001.
Skull base defects are classified into three regions based on the anatomic location and growth pattern of the tumors. The goals of reconstruction are based on the necessity of obtaining a watertight seal between the cranial contents and the aerodigestive tract, thereby avoiding any communication, which could result in ascending meningitis. Pedicled flap options have largely been replaced by free tissue transfers, with the exception of small Zone I defects that can still be safely reconstructed with local pedicle flaps. The rectus abdominis free muscle flap has become the workhorse of skull base reconstruction, resulting in a decrease in the complication rate following these procedures. Various other factors have significantly improved the prognosis of patients who require tumor ablation involving the skull base.
根据肿瘤的解剖位置和生长模式，颅底缺损可分为三个区域。重建的目标基于在颅内容物与气道消化道之间获得防水密封的必要性，从而避免任何可能导致上行性脑膜炎的相通情况。除了仍可通过局部带蒂皮瓣安全重建的小的I区缺损外，带蒂皮瓣选择在很大程度上已被游离组织移植所取代。腹直肌游离肌皮瓣已成为颅底重建的主力，使这些手术后的并发症发生率降低。各种其他因素显著改善了需要进行涉及颅底肿瘤切除的患者的预后。
