Hackman Trevor G
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, N.C.
Plast Reconstr Surg Glob Open. 2016 Nov 23;4(11):e1109. doi: 10.1097/GOX.0000000000001109. eCollection 2016 Nov.
Skull base surgical defects present unique challenges to anatomic and functional reconstruction. Fortunately, many endonasal skull base defects are successfully managed with a variety of local and regional reconstructive techniques. However, when prior surgery or radiotherapy eliminates the use of these local and regional reconstructive options, more elaborate free tissue transfer techniques are required. Managing endoscopic skull base defects of the anterior cranial fossa and clivus is further complicated by the limited access afforded for flap inset. The following case report describes durable reconstruction of a clival defect with an endoscopically-tunneled adipofascial radial forearm tissue transfer. The case highlights importance of a multidisciplinary surgical team approach with strong foundations in endonasal skull base and reconstructive surgery to achieve successful reconstruction of complex endonasal defects.
颅底手术缺损给解剖和功能重建带来了独特的挑战。幸运的是，许多鼻内镜下颅底缺损可通过多种局部和区域重建技术成功处理。然而，当先前的手术或放疗排除了这些局部和区域重建选择时，就需要更复杂的游离组织移植技术。前颅窝和斜坡的鼻内镜颅底缺损的处理因皮瓣植入的操作空间有限而更加复杂。以下病例报告描述了通过鼻内镜下隧道化的桡侧前臂脂肪筋膜组织移植对斜坡缺损进行持久重建。该病例突出了多学科手术团队方法的重要性，该方法以鼻内镜颅底手术和重建手术的坚实基础为依托，以实现复杂鼻内镜缺损的成功重建。
