Free tissue transfer and local flap complications in anterior and anterolateral skull base surgery.

Research paper by Jason A JA Heth, Gerry F GF Funk, Lucy H LH Karnell, Timothy M TM McCulloch, Vincent C VC Traynelis, Jeffrey A JA Nerad, Russell B RB Smith, Scott M SM Graham, Henry T HT Hoffman

Indexed on: 09 Oct '02Published on: 09 Oct '02Published in: Head & Neck


Advances in reconstructive techniques over the past two decades have allowed the resection of more extensive skull base tumors than had previously been possible. Despite this progress, complications related to these cases remain a concern.Univariate and multivariate analyses were used to determine the relationship of host, tumor, defect, treatment, and reconstructive variables to wound and systemic complications after anterior and anterolateral skull base resections. The study included 67 patients receiving local flap (LF) or free tissue transfer (FTT) reconstructions during an 8-year period.Overall, 28% of patients had a major wound complication, and 19% had a major systemic complication. LF and FTT flaps had similar rates of wound complications. LF reconstructions were associated with late wound breakdown problems, and FTT flap complications were primarily acute surgery-related problems.The surgical reconstruction of skull base defects should be planned on the basis of the ability of the technique to attain safe closure and maintain integrity after radiation therapy.

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