title: Translocated pedicled buccal fat pad:  closure of anterior and middle skull base defects after tumor resection.
abstract: BACKGROUND
  Problem of closure of skull base defects after removal of craniobasal lesions, especially, craniofacial, is one of the most challenging in neurosurgery. Persistent skull base defect produces extremely high risk of cerebrospinal fluid leaks and consecutive infectious complications. Local pedicled grafts are the preferred material for plasty. In this study, the authors present original technique of using a pedicled buccal fat pad (BFP) graft. Anatomy and functions of BFP are discussed in details as well as surgical technique illustrated by 2 case reports.
  
  
  METHODS
  From 2004 to 2010, 188 patients with anterior and middle skull base mass lesions were operated on in Burdenko Neurosurgical Institute (Moscow, Russia) using BFP as plastic material for closure of different defects (male-female ratio=61:127; mean age was 47 years [range, 10-74 years]).
  
  
  RESULTS
  In 93.6% of cases, pedicled BFP flap was applied; in 6.4%, free flap was used. Follow-up period ranged between 1 and 7 years. Only 1 case of postoperative cerebrospinal fluid leak was observed; flap rejection was not registered in the series.
  
  
  CONCLUSIONS
  High effectiveness and minimal invasiveness are principal advantages of the described technique, which is applied in neurosurgery for the first time. Other benefits include proximity of donor site and defect, simplicity of surgical technique, minimal postoperative discomfort, and very low risk of benign complications.
authors.affiliation: Department of Skull Base and Craniofacial Surgery, Burdenko Neurosurgery Institute, Moscow, Russia.
authors.forename: Vasily A
authors.initials: VA
authors.lastname: Cherekaev
authors.forename: Denis A
authors.initials: DA
authors.lastname: Golbin
authors.forename: Alexander I
authors.initials: AI
authors.lastname: Belov
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D018322:Angiofibroma / Q000601:surgery; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D002648:Child; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006085:Graft Survival; D006801:Humans; D008297:Male; D008579:Meningioma / Q000601:surgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009455:Neurofibroma / Q000601:surgery; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D019291:Skull Base / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000601:surgery*; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives