Pedicled Extranasal Flaps in Skull Base Reconstruction

Kim, Grace G.; Hang, Anna X.; Mitchell, Candace A.; Zanation, Adam M.

doi:10.1159/000342282

Cited by 41 publications

(62 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,7,10,11 In this report we describe utilization of the tunneled TPF flap for skull base reconstruction after EEA in a pediatric patient.…”

Section: Discussionmentioning

confidence: 99%

“…5,12,14 Intranasal flaps may not be available for reconstructive use if the donor site or its vascular supply is compromised by the primary pathology or as a result of prior radiation or surgical treatment. When intranasal flaps are unavailable, other reconstructive options include free-tissue grafts, regional extranasal flaps, 7 and microvascular free-tissue flaps from distant donor sites. The temporoparietal fascia (TPF) flap is a regional scalp flap with well-established utility in open surgery for the reconstruction of lateral skull, auricular, and facial defects.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Pediatric skull base reconstruction: case report of a tunneled temporoparietal fascia flap

Rastatter¹,

Walz²,

Alden

2016

PED

View full text Add to dashboard Cite

The authors of this report present a pediatric case involving the use of a tunneled temporoparietal fascia flap to reconstruct a skull base defect for a multiply recurrent clival chordoma and cerebrospinal fluid leak, demonstrate the surgical technique through illustrations and intraoperative photos, and review the pertinent literature. A 9-year-old female patient underwent extensive clival chordoma resection via both the endoscopic and open approaches, which ultimately exhausted the bilateral nasoseptal flaps and other intranasal reconstructive options. Following proton beam radiation and initiation of chemotherapy, tumor recurrence was managed with further endoscopic resection, which was complicated by a recalcitrant cerebrospinal fluid leak. A tunneled temporoparietal fascia flap was used to provide vascular tissue to augment an endoscopic repair of the leak and reconstruction of the skull base. While the nasoseptal flap remains the workhorse for many pediatric and adult endoscopic skull base reconstructions, the tunneled temporoparietal fascia flap has a demonstrated efficacy in adults when the nasoseptal flap and other intranasal flaps are unavailable. This report documents a pediatric case, serving as a step toward establishing this technique in the pediatric population.

show abstract

“…4,7,10,11 In this report we describe utilization of the tunneled TPF flap for skull base reconstruction after EEA in a pediatric patient.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Pediatric skull base reconstruction: case report of a tunneled temporoparietal fascia flap

Rastatter¹,

Walz²,

Alden

2016

PED

View full text Add to dashboard Cite

show abstract

“…7 The advantage of free flaps is their reliability, versatility, and ability to be harvested simultaneously with the resection using a two-team approach to reduce operative time. [8][9][10] CONCLUSION Surgical salvage after residual or recurrent nasopharyngeal carcinoma has been shown to achieve better control than re-irradiation. Reconstruction is necessary after resection for defect coverage and promotion of healing to prevent carotid artery blow out and osteoradionecrosis.…”

Section: Discussionmentioning

confidence: 99%

Reconstructive Flaps After Salvage Nasopharyngectomy

Thakkar¹,

Grossman²,

Lin³

et al. 2016

Otolaryngol Open J.

View full text Add to dashboard Cite

Importance: The emergence of new technologies for early diagnosis of recurrent nasopharyngeal cancer and new techniques of endoscopic nasopharyngectomy increase the incidence of salvage nasopharyngectomy and pose the question of the ideal flap for reconstruction of this defect. Objectives: A review of the literature to identify the flaps used in nasopharyngeal reconstruction and their advantages and disadvantages, characteristics, and outcomes. Methods: We reviewed the literature available in the English language to identify the various flaps used, their indications and surgical technique, complications and outcomes. Results: Multiple flaps have been used. Local mucosal flaps such as the posterior pedicled middle turbinate mucoperiosteal flap, the posterior pedicled Nasal Septal Flap (NSF) and Floor mucoperiosteum flap (FF), pedicled flaps such as the extended glabellar fascial cutaneous flap, the Haddad-Bassagasteguy flap, the temporoparietal fascial flap and the pericranial flap and free flaps such as the radial forearm and vastus lateralis flap have been described. These flaps are used depending on the specific defect characteristics and tissue available for reconstruction. The advantages and disadvantages of these flaps are discussed. Conclusion: No single flap is ideal for all cases. The choice of flap will have to be tailored according to the patient, the defect created, consistent with oncologic principles, donor site availability and surgeon preference. A working knowledge of available flaps is essential to provide coverage of the skull base to avoid vascular and infectious complications.

show abstract

“…11,12 Multiple flaps for complex skull base defects should be in the armamentarium of comprehensive skull base surgery centers. 25,29 Multilayer cranial base reconstruction has been reported to lead to satisfactory results in preventing delayed frontal lobe sagging.…”

Section: Nasoseptal Flapmentioning

confidence: 99%

Surgical anatomy and utility of pedicled vascularized tissue flaps for multilayered repair of skull base defects

Safavi–Abbasi

Komune

Archer

et al. 2016

JNS

View full text Add to dashboard Cite

OBJECT The objective of this study was to describe the surgical anatomy and technical nuances of various vascularized tissue flaps. METHODS The surgical anatomy of various tissue flaps and their vascular pedicles was studied in 5 colored silicone-injected anatomical specimens. Medical records were reviewed of 11 consecutive patients who underwent repair of extensive skull base defects with a combination of various vascularized flaps. RESULTS The supraorbital, supratrochlear, superficial temporal, greater auricular, and occipital arteries contribute to the vascular supply of the pericranium. The pericranial flap can be designed based on an axial blood supply. Laterally, various flaps are supplied by the deep or superficial temporal arteries. The nasoseptal flap is a vascular pedicled flap based on the nasoseptal artery. Patients with extensive skull base defects can undergo effective repair with dual flaps or triple flaps using these pedicled vascularized flaps. CONCLUSIONS Multiple pedicled flaps are available for reconstitution of the skull base. Knowledge of the surgical anatomy of these flaps is crucial for the skull base surgeon. These vascularized tissue flaps can be used effectively as single or combination flaps. Multilayered closure of cranial base defects with vascularized tissue can be used safely and may lead to excellent repair outcomes.

show abstract

Pedicled Extranasal Flaps in Skull Base Reconstruction

Cited by 41 publications

References 17 publications

Pediatric skull base reconstruction: case report of a tunneled temporoparietal fascia flap

Pediatric skull base reconstruction: case report of a tunneled temporoparietal fascia flap

Reconstructive Flaps After Salvage Nasopharyngectomy

Surgical anatomy and utility of pedicled vascularized tissue flaps for multilayered repair of skull base defects

Contact Info

Product

Resources

About