Outcomes following Microvascular Free Tissue Transfer in Reconstructing Skull Base Defects.
Objective Successful resection of complex tumors involving the skull base (SB) depends on the ability to reconstruct the resulting defects. The objective of this study was to assess the outcomes of patients undergoing reconstruction after resection of SB tumors with free flaps. Methods From 1995 to 2010 a retrospective review of cases was undertaken. Demographics, histology, surgical management, complications, locoregional control, and survival were analyzed. Results We performed 62 flaps in 57 patients. There was a preponderance of sinonasal malignancies (45%), and most lesions involved the anterior SB (81%). A total of 94% of patients underwent radiotherapy. Reconstruction was undertaken mainly with anterolateral thigh (37%) or radial forearm (34%) flaps. Complications occurred in 17% of patients, and the flap's success rate was 94%. Conclusion Free flaps are versatile and highly reliable for reconstructing defects resulting from resections of the SB. They should be considered for SB reconstruction of large three-dimensional defects as well as defects involving an irradiated field. Successful reconstruction of the SB can be performed using a small number of highly dependable flaps.
Department of Otorhinolaryngology, Skull Base Unit, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Jose L
JL
Llorente
Department of Otorhinolaryngology, Skull Base Unit, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Fernando
F
Lopez
Department of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Daniel
D
Camporro
Department of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Angel
A
Fueyo
Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Juan C
JC
Rial
Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Ramon Fernandez
RF
de Leon
Department of Otorhinolaryngology, Skull Base Unit, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Carlos
C
Suarez
free flaps; head and neck reconstruction; microvascular free tissue transfer; skull base; skull base defects