Successful closure of recurrent traumatic csf rhinorrhea using the free rectus abdominis muscle flap

Free Flap Reconstruction of the Scalp and Calvaria of Major Neurosurgical Resections in Cancer Patients: Lessons Learned Closing Large, Difficult Wounds of the Dura and Skull

“…Treatment of cranial base defects with cerebrospinal fluid leak using free tissue transfer has been successfully demonstrated by some. [13][14][15] Our study focuses on cranial vault defects that have been reconstructed with free flaps. Although our goal in reconstruction was primarily to close the defect, we wanted to examine whether cerebrospinal fluid leakage could also Plastic and Reconstructive Surgery • March 2007 be treated successfully with the free flap.…”

“…5 Many studies have examined the role of reconstruction of scalp defects using free flaps. 6 -12 Although the literature has a multitude of articles addressing cerebrospinal fluid leak from the cranial base, [13][14][15] no article specifically addresses cerebrospinal fluid leakage that results from scalp and calvarial defects. Dural healing is promoted by bringing in well-vascularized, healthy tissue from a distant site.…”

Porencephalic Cyst

“…Other complications include distal hypertonicity, spasticity, and truncal ataxia (3). Rarely does a porencephalic cyst lead to or present with CSF rhinorrhea or otorrhea (6,7). The prognosis of porencephaly is not dependent on the cause but rather on the location and extent of the cyst (2).…”

“…Further workup revealed a posttraumatic porencephalic cyst of the mastoid. The tegmen defect that allowed displacement of the cyst into the mesotympanum and antrum was repaired with temporalis fascia, a bone plug, and a rotating sternocleidomastoid muscle flap (7). Porencephaly may also present with CSF rhinorrhea especially if the defect is in the paranasal sinuses.…”

Radial Forearm Free Tissue Transfer in the Management of Persistent Cerebrospinal Fluid Leaks

“…Vascularized flaps are particularly effective for use in patients with a history of prior radiation or whose local and regional tissues have compromised blood supply. Review of the literature demonstrates a paucity of studies regarding the efficacy of free tissue transfer in the management of challenging CSF leaks 6–8 . Prior studies have been anecdotal and consisted of small groups of patients managed with various types of repair.…”