[Free tissue transfer for skull base reconstruction of advanced oncological defects].
OBJECTIVE
To analyze the results and the indications of free flaps in the skull base reconstruction.


METHODS
A retrospective review was performed of 25 free flaps reconstructions for skull base tumor ablation defects between March of 1999 and March of 2009. There were 9 latissimus dorsi flaps, 6 rectus abdominis flaps, 4 deep inferior epigastric artery perforator flaps, 3 anterolateral thigh flaps, 2 radial forearm flaps and 1 fibular flap. The defects were classified as cranial bone (100%), dura (40%), brain (12%), sino-nasal cavity (52%), mucosa (56%) and skin (80%).


RESULTS
Twenty-three of 25(92%) free flaps survived. One total flap failure and 1 partial flap failure occurred. Five patients (20%) had central nervous system related postoperative complications which including 1 mortality, 2 central nerve system infection and 2 cerebrospinal fluid fistula.


CONCLUSIONS
Free flaps transfer is a reliable reconstruction technique for cranial base surgery. This provides a solution to the select advances disease otherwise surgical contraindications. Free flap is the choice for reconstruction of advanced oncological defects, especially when skin and mucosa are violated.
Zhang
Bin
B
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. docbinzhang@hotmail.com
Wan
Jing-hai
JH
Zhang
Yong-xia
YX
An
Chang-ming
CM
Xu
Zhen-gang
ZG
Tang
Ping-zhang
PZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery; D017695:Soft Tissue Injuries / Q000601:surgery*; D055815:Young Adult