Skull Base Reconstruction

Skull Base Reconstruction
Dr. Ebrahim Karimi

Reconstruction of skull base defects following tumor resection is of paramount importance in avoiding serious and life-threatening complications. Thus, a successful outcome following skull base tumor ablation often depends as much on the reconstruction as it does on the resection.

The creation of a functional separation of the intracranial and extracranial cavities can be extremely difficult to accomplish, especially when multiple cavities (nasal, oral, pharyngeal) are violated.

A wide variety of options, ranging from grafts and alloplastic implants to local, regional, and distant re-vascularized free flaps, are available for skull base reconstruction.

we recommend using regional flaps for small defects based on minimal donor site morbidity, and shorter operative times, ICU, and hospital stays, particularly in Region III.

Supraclavicular artery flap was most useful Regional flap because of easy harvesting technique and equivalent results to free tissue transfer.

For extensive defects, and in cases involving prior surgery, radiation, or chemotherapy, free flaps are preferred. The anterolateral thigh and rectus abdominis myocutaneous free flaps were useful for large defects, especially those involving multiple regions and when multiple skin paddles were required.