Hanasono Matthew M
The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 443, Houston, TX, 77030, USA.
J Neurooncol. 2020 Dec;150(3):469-475. doi: 10.1007/s11060-019-03370-1. Epub 2020 Feb 13.
Resection of skull base malignancies that would have been associated with unacceptable morbidity and mortality in the past are now performed with reliable results due in large part to advancements in reconstructive surgery. The goal of this review is to describe the best evidence-based methods of reconstruction following open surgery for skull base tumors in order to attain improved outcomes for patients.
A review of recent studies involving reconstruction following open skull base surgeries was performed.
Free flaps are now the most commonly recommended method for reconstruction following open skull base surgery, although pedicled regional flaps such as the temporalis muscle, supraclavicular, and submental flaps may be good alternatives in specific cases. Recent series suggest high reconstructive free flap survival rates and low levels of recipient site complications, including neurosurgical complications such as cerebrospinal fluid leak. The location of the resection defect predicts the reconstructive challenges and guides pedicled and free flap selection.
Refinements in flap selection and reconstructive technique continue to improve patient outcomes and decrease complication rates following open surgery for skull base malignancies.
过去因手术死亡率和发病率过高而无法进行的颅底恶性肿瘤切除术，如今由于重建手术的进展，已能取得可靠的效果。这篇综述的目的是描述颅底肿瘤开放手术后基于最佳证据的重建方法，以改善患者的治疗效果。
对近期有关颅底开放手术后重建的研究进行综述。
游离皮瓣目前是颅底开放手术后最常推荐的重建方法，不过在特定情况下，带蒂局部皮瓣，如颞肌瓣、锁骨上皮瓣和颏下皮瓣，可能是不错的替代选择。近期的系列研究表明，游离皮瓣重建的存活率较高，受区并发症发生率较低，包括脑脊液漏等神经外科并发症。切除缺损的位置预示着重建的挑战，并指导带蒂皮瓣和游离皮瓣的选择。
皮瓣选择和重建技术的改进持续改善了颅底恶性肿瘤开放手术后的患者治疗效果，并降低了并发症发生率。
