Successful Reconstruction of Refractory Posttraumatic Skull Base Defects with the Free Radial Forearm Flap

Lorenzini, M.; Mazza, Carlo; Scevola, Silvia; Barisoni, D.

doi:10.1097/00006534-199811000-00044

Cited by 8 publications

(3 citation statements)

References 16 publications

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“…Traumatic facial nerve palsy is a common cause of facial paralysis that the clinician is likely to encounter 1 . In a large series reported by May, 17% of patients with facial paralysis had trauma as the cause 2 .…”

Section: Discussionmentioning

confidence: 99%

Facial nerve decompression via posterior tympanotomy approach in traumatic facial nerve palsy

Paul¹,

Sabrigirish²,

Choudhury³

et al. 2010

The Indian Journal of Neurotrauma

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Section: Discussionmentioning

confidence: 99%

Facial nerve decompression via posterior tympanotomy approach in traumatic facial nerve palsy

Paul¹,

Sabrigirish²,

Choudhury³

et al. 2010

The Indian Journal of Neurotrauma

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“…6 The RFFF can be used in anterior and lateral skull base reconstructions with good results. 6 Lorenzini et al 7 have reported the use of RFFF to reconstruct refractory post-traumatic anterior skull base defects. One of their patients had recurrent meningitis from an ethmoidal encephalocele, and the other had a persistent CSF leak after a gunshot wound.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Complicated Skull Base Defects Utilizing Free Tissue Transfer

Djalilian

Gapany²,

Levine³

2002

Skull Base

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We managed five patients with large skull base defects complicated by complex infections with microvascular free tissue transfer. The first patient developed an infection, cerebrospinal fluid (CSF) leak, and meningitis after undergoing a translabyrinthine resection ofan acoustic neuroma. The second patient had a history of a gunshot wound to the temporal bone, with a large defect and an infected cholesteatoma that caused several episodes of meningitis. The third through the fifth patients had persistent CSF leakage and infection refractory to conventional therapy. In all cases prior attempts of closure with fat grafts or regional flaps had failed. Rectus abdominis myofascial free flap, radial forearm free flap or a gracilis muscle free flap was used after debridement of the infected cavities. The CSF leaks, local infections, and meningitis were controlled within a week. In our experience, microvascular free tissue provides the necessary bulk ofviable, well-vascularized tissue, which not only assures a mechanical seal but also helps clear the local infection.

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“…4,5 The pericranial flap is most commonly used for primary repair; use of skin, galeal, and various free muscle flaps has been described in patients who do not have sufficient native tissue. 3,6,7 To provide more rigid fixation, some authors have also reported using bone grafts and metallic mesh in conjunction with soft-tissue repair. Because of the higher risk of postoperative infections, however, the application of avascular tissue has not become popular.…”

mentioning

confidence: 99%

Use of titanium mesh for reconstruction of large anterior cranial base defects

Badie

Preston²,

Hartig³

2000

Journal of Neurosurgery

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The authors evaluated the role of titanium mesh used in combination with vascularized pericranium to provide rigid support during reconstruction of anterior skull base defects. Thirteen patients with large anterior skull base defects caused by tumor invasion or traumatic injury involving the cribriform plate, orbital roof, and planum sphenoidale were included in the study. The reconstruction technique involved placement of titanium mesh between two layers of continuous vascularized pericranium. Surgical glue and routine lumbar cerebrospinal fluid (CSF) drainage were not used in any patient. At a mean postoperative follow-up time of 22 months (range 8-39 months), none of the patients had developed infection or meningocele. Postoperative CSF rhinorrhea occurred in two patients with extensive dural defects, which resolved with temporary lumbar drainage. Use of titanium mesh and a two-layer vascularized pericranial graft is a safe, reproducible, and feasible method for reconstructing the anterior skull base. Patients with large dural defects may need temporary CSF diversion to avoid postoperative fistula formation.

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Successful Reconstruction of Refractory Posttraumatic Skull Base Defects with the Free Radial Forearm Flap

Cited by 8 publications

References 16 publications

Facial nerve decompression via posterior tympanotomy approach in traumatic facial nerve palsy

Facial nerve decompression via posterior tympanotomy approach in traumatic facial nerve palsy

Reconstruction of Complicated Skull Base Defects Utilizing Free Tissue Transfer

Use of titanium mesh for reconstruction of large anterior cranial base defects

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