The versatile extended pericranial flap for closure of skull base defects.

Otolaryngol Head Neck Surg 2004 Jun;130(6):704-11

Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, USA.

Objective: We sought to demonstrate the technical aspects of the extended pericranial flap and its versatility in reconstruction of a variety of skull base defects.

Study Design: We conducted a retrospective chart review of 32 patients who underwent reconstruction of skull-base defects with an extended pericranial flap by the senior author (Y.D.) from September 1997 to July 2003.

Methods: Patients with skull base defects after trauma or extirpative surgery were reconstructed with either a lateral- or an anterior-based vascularized extended pericranial flap. Variables and outcomes measured included: the size and anatomical location of the defect, need for other flaps, preoperative and/or postoperative radiation therapy and/or chemotherapy, bone flap necrosis, hardware exposure, wound dehiscence, postoperative cerebrospinal fluid (CSF) leak, and meningitis.

Results: There was no evidence of flap failure, 2 cases of transient (3 to 4 days) CSF leak without resultant meningitis, 3 patients with hardware exposure, and 2 patients with hydroxyapatite infection. The 2 transient cases of CSF leak both resolved without further surgical intervention or the placement of a lumbar drain.

Conclusion: Both the lateral and anteriorly based extended pericranial flaps are reliable and versatile flaps associated with minimal morbidity and a low rate of complications when used to reconstruct defects of the anterolateral skull base.

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http://dx.doi.org/10.1016/j.otohns.2004.01.004DOI Listing
June 2004
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References

(Supplied by CrossRef)

Briant TDR et al.
J Otolaryngol 1993

Abul-Hassan HS et al.
Plast Reconstr Surg 1986

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