Head and Neck Oncologic Surgery Unit, Institut Curie, 26 rue d'Ulm, 75005 Paris, France.
J Craniomaxillofac Surg. 2012 Feb;40(2):177-9. doi: 10.1016/j.jcms.2011.01.023. Epub 2011 Mar 9.
Surgery of extensive skull base tumour results of a defect of soft and hard tissue and dura. Free flap reconstruction provides tissue to restore the defect and separate the intracranial content from the bacterial flora of the nasal fossae. Vertical and transverse rectus abdominis myocutaneous free flap are usually used. This study was designed to compare our experience of latissimus dorsi free flap reconstruction of extensive skull base defects after tumour resection with the literature concerning the use of other types of free flaps.
All extensive skull base tumour resections with latissimus free flap reconstruction made in the head and neck oncology unit of the Institut Curie, Cancer Centre, between January 2004 and December 2009 were reviewed.
Two infectious complications were observed (11.7%), two cases of CSF leak (11.7%), one case of wound dehiscence following tumour resection comprising the nasal skin (5.9%) and one case of partial distal necrosis of the flap in a zone of skin resection (5.9%) were observed. No flaps were lost. Two latissimus dorsi donor site haematomas were observed (11.7%).
When reconstruction of extensive skull base defect need free flap, the latissimus dorsi free flap is a reliable solution.
广泛颅底肿瘤手术会导致软组织、硬组织和硬脑膜缺损。游离皮瓣重建可提供组织来修复缺损，并将颅内内容物与鼻腔菌群分隔开。通常使用垂直和横向腹直肌肌皮瓣。本研究旨在比较我们在切除肿瘤后使用Latissimus dorsi 游离皮瓣重建广泛颅底缺损的经验与文献中关于使用其他类型游离皮瓣的经验。
回顾了 2004 年 1 月至 2009 年 12 月期间在巴黎居里研究所癌症中心头颈肿瘤科进行的所有广泛颅底肿瘤切除并使用 Latissimus 游离皮瓣重建的病例。
观察到 2 例感染并发症（11.7%）、2 例脑脊液漏（11.7%）、1 例肿瘤切除后包括鼻皮肤在内的伤口裂开（5.9%）和 1 例皮瓣切除区部分远端坏死（5.9%）。无皮瓣丢失。观察到 2 例 Latissimus dorsi 供区血肿（11.7%）。
当需要游离皮瓣重建广泛颅底缺损时，Latissimus dorsi 游离皮瓣是一种可靠的解决方案。
