Microvascular reconstruction of cranial base defects: An evaluation of complication and survival rates to justify the use of this repair

Archives of Otolaryngology--head & Neck Surgery
Jason NewmanMark T Brown

Abstract

To describe our experience, including selection criteria and complication rates, using microvascular free tissue transfer to repair large skull base defects and to determine if complication rate and posttreatment survival justify the use of this technique. Retrospective review of clinical cohort. Tertiary care medical center. A consecutive sample of patients undergoing ablative surgery with repair of cranial base defects with free tissue transfer from 1995 to 2004. All the patients' defects involved intracranial exposure. Rate of local and systemic complications, postoperative survival, and recurrence rate. The study population comprised 40 patients. Fifteen (38%) of the patients' defects were in the anterior cranial base, and 26 (65%) were in the middle cranial base. We used 5 types of free tissue flap, with a success rate of 95%. Our rate of perioperative mortality, meningitis, stroke, cerebrospinal fluid leak, epidural abscess, and osteomyelitis was 0%. We had 7 local complications and 4 systemic complications requiring increased length of hospital stay. Including microvascular problems, 12 patients had complications, for an overall complication rate of 30%. Follow-up ranged from 1 to 96 months, with a mean of 24 months. The...Continue Reading

Citations

Dec 4, 2012·World Neurosurgery·Scharukh JalisiLawrence Chin
Jun 15, 2016·The Journal of Craniofacial Surgery·Tomoyuki YanoSatoshi Usami

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