title: Skull base reconstruction using various types of galeal flaps.
abstract: BACKGROUND
  Failure of skull base reconstruction is a life-threatening issue. This study describes surgical techniques utilising various types of galeal flaps and reports on outcome of these procedures for skull base reconstruction.
  
  
  METHODS
  Clinical records of 136 patients (75 men, 61 women; mean age, 50.0 years) who required skull base reconstruction with galeal flaps were reviewed retrospectively. Patients had undergone skull base surgeries with simultaneous reconstruction for benign tumours in 77 patients, malignant tumours in 53, and other lesions in 6. We repaired dural defects using a fascial patch, and covered the skull base defects using various types of galeal flap according to the size and location of the skull base defects. Routine spinal drainage was not used in any patients.
  
  
  RESULTS
  Reconstruction was performed as planned in all patients. We utilised a galea frontalis flap in 17 patients, temporoparietal galeal flap in 95, temporoparietal galeal flap with calvarial bone in 9, and bipedicled temporoparietal galeal flap in 15. Postoperative complications included scalp wound necrosis in 8 patients (5.9%), transient leakage of cerebrospinal fluid in 3 (2.2%), and intracranial infection in 2 (1.5%). Necrosis of the galeal flaps was not encountered.
  
  
  CONCLUSIONS
  Galea is a well-vascularised tissue with homogenous thickness. Since the galeal layer covers the entire head area, various types of galeal flap can be elevated to cover any size and location of skull base defect.
authors.affiliation: Department of Neurosurgery, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Ito
authors.forename: Tadashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Taku
authors.initials: T
authors.lastname: Sato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Oda
authors.forename: Yuka
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ando
authors.forename: Jun
authors.initials: J
authors.lastname: Sakuma
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Saito
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012535:Scalp / Q000098:blood supply / Q000637:transplantation*; D019291:Skull Base / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000592:standards*; D016378:Tissue Transplantation / Q000379:methods*