title: The use of free flaps in skull base reconstruction.
abstract: Skull base tumours are rare, comprising less than 1% of all tumours of the head and neck. Surgical treatment of these tumours involves the approach, the resection, and the reconstruction of the defect, which present a challenge due to the technical difficulty and anatomical complexity. A retrospective study of 17 patients with tumours involving the skull base, treated by resection and immediate reconstruction using microsurgical free flaps, is presented; 11 were men and six were women. The following types of flap were used: osteocutaneous fibula flaps, fasciocutaneous anterolateral thigh flaps, and myocutaneous latissimus dorsi flaps. The most common histology of the tumours was squamous cell carcinoma. The most frequent point of origin was the paranasal sinuses (58.8%). All of the free flaps used for reconstruction were viable. A cerebrospinal fluid fistula occurred in two patients, and in one of these cases, meningoencephalitis led to death. In conclusion, the reconstruction of large defects of the skull base after ablation requires a viable tissue that in many cases can be obtained only through the use of microvascular free flaps. The type of flap to be selected depends on the anatomical structures and size of the defect to be restored.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain. Electronic address: german.macia@yahoo.es.
authors.forename: G
authors.initials: G
authors.lastname: Macía
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Picón
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Nuñez
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Almeida
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Alvarez
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Acero
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*; D013848:Thigh; D016896:Treatment Outcome
keywords: free flap; reconstruction; skull base