Kim Shin Hyun, Lee Won Jai, Chang Jong Hee, Moon Joo Hyung, Kang Seok Gu, Kim Chang Hoon, Hong Jong Won
Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.
Arch Craniofac Surg. 2021 Oct;22(5):232-238. doi: 10.7181/acfs.2021.00290. Epub 2021 Oct 20.
Galeal or temporalis muscle flaps have been traditionally used to reconstruct skull base defects after tumor removal. Unfortunately, these flaps do not provide sufficient vascularized tissue for a dural seal in extensive defects. This study describes the successful coverage of large skull base defects using anterolateral thigh (ALT) free flaps.
This retrospective study included five patients who underwent skull base surgery between June 2018 and June 2021. Reconstruction was performed using an ALT free flap to cover defects that included the intracranial space and extended to the frontal sinus and cribriform plate.
There were no major complications, such as ascending infections or cerebrospinal leakage. Postoperative magnetic resonance imaging showed that the flaps were well-maintained in all patients.
Successful reconstruction was performed using ALT free flaps for large anterior skull base defects. In conclusion, the ALT free flap is an effective option for preventing communication between the nasal cavity and the intracranial space.
传统上一直使用帽状腱膜瓣或颞肌瓣在肿瘤切除后重建颅底缺损。不幸的是,对于广泛的缺损,这些瓣无法提供足够的血管化组织用于硬脑膜封闭。本研究描述了使用股前外侧(ALT)游离皮瓣成功覆盖大型颅底缺损的情况。
这项回顾性研究纳入了2018年6月至2021年6月期间接受颅底手术的5例患者。使用ALT游离皮瓣进行重建,以覆盖包括颅内空间并延伸至额窦和筛板的缺损。
未发生诸如上行性感染或脑脊液漏等重大并发症。术后磁共振成像显示所有患者的皮瓣均保持良好。
使用ALT游离皮瓣成功重建了大型前颅底缺损。总之,ALT游离皮瓣是预防鼻腔与颅内空间相通的有效选择。