游离组织移植在颅底重建中的作用。

Role of free tissue transfer in skull base reconstruction.

作者信息

Weber Stephen M, Kim Jason H, Wax Mark K

机构信息

Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR 97239, USA.

出版信息

Otolaryngol Head Neck Surg. 2007 Jun;136(6):914-9. doi: 10.1016/j.otohns.2006.12.030.

DOI:10.1016/j.otohns.2006.12.030

PMID:17547979

Abstract

OBJECTIVE

Free tissue transfer to the skull base provides a watertight seal to prevent CSF leakage and donor tissue tailored to the individual defect.

STUDY DESIGN AND SETTING

Retrospective chart review of 38 patients who underwent free tissue transfer to the skull base between November 1995 and October 2005 at an academic, tertiary referral center.

RESULTS

There were 23 male and 15 female patients (average age, 58.1 years) with skull base defects resulting from oncologic resection or head trauma most frequently. Donor sites included the radial forearm (25), rectus abdominis (12), latissimus dorsi (4), anterolateral thigh, scapula, serratus anterior, and ulna (1 each). Seven patients required a second free tissue transfer indicated for flap death (3), partial flap necrosis (2), pneumocephalus (1), or tumor recurrence (1). Two patients died in the immediate postoperative period.

CONCLUSIONS

Free tissue transfer is a robust option in the repair of post-surgical and post-traumatic skull base defects.

摘要

目的

将游离组织转移至颅底可提供防水密封以防止脑脊液漏，并根据个体缺损定制供体组织。

研究设计与背景

对1995年11月至2005年10月期间在一家学术性三级转诊中心接受游离组织转移至颅底手术的38例患者进行回顾性病历审查。

结果

共有23例男性和15例女性患者（平均年龄58.1岁），颅底缺损最常见的原因是肿瘤切除或头部外伤。供体部位包括桡侧前臂（25例）、腹直肌（12例）、背阔肌（4例）、股前外侧、肩胛骨、前锯肌和尺骨（各1例）。7例患者因皮瓣坏死（3例）、部分皮瓣坏死（2例）、气颅（1例）或肿瘤复发（1例）需要再次进行游离组织转移。2例患者在术后即刻死亡。