Department of Plastic and Reconstructive Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Microsurgery. 2012 Nov;32(8):622-6. doi: 10.1002/micr.22025. Epub 2012 Sep 13.
Despite the recent advances in microsurgical techniques, reconstruction of extensive skull base defects using free flaps in pediatric patients presents a surgical challenge, and reports on skull base reconstruction in infants is quite limited. We present a case of reconstruction of an extensive anterior skull base defect using a rectus abdominis (RA) myocutaneous flap in a 1 year-old (14 months) infant. Sufficient coverage of the intracranial contents, good aesthetic results, and minimal growth disturbance at the donor site were achieved by the muscle-sparing RA flap transfer. To the best of our knowledge, this was among the youngest case of skull base reconstruction using a free flap. The feasibility of free flap transfer and flap selection in pediatric skull base reconstruction is discussed.
尽管最近在显微外科技术方面取得了进展，但对于小儿患者，使用游离皮瓣来重建广泛的颅底缺损仍然是一项具有挑战性的手术，并且关于婴儿颅底重建的报道非常有限。我们报告了一例 1 岁（14 个月）婴儿使用腹直肌（RA）肌皮瓣重建广泛前颅底缺损的病例。通过保留肌肉的 RA 皮瓣转移，实现了对颅内内容物的充分覆盖，获得了良好的美学效果，并且供区的生长干扰最小。据我们所知，这是使用游离皮瓣进行颅底重建的最年幼的病例之一。本文讨论了游离皮瓣移植在小儿颅底重建中的可行性和皮瓣选择。
