Closure of Complex Lateral Skull Base Defects

Abstract

To discuss surgical reconstructive options and complications in patients with extensive lateral skull base defects. Retrospective case review. Tertiary referral center. Eligibility criteria included patients seen between July 1999 and July 2003 with malignant neoplasms of the lateral skull base requiring surgical therapy, with resultant surgical defect not amenable to primary closure. Surgical extirpation of malignant skull base neoplasm requiring free tissue transfer or rotational flap closure. Closure and healing of surgical defect, intraoperative and postoperative complications, patient survival. There were 11 patients, 8 males and 3 females, with an average age of 65 years. Eight patients required trapezius flap reconstruction, whereas one patient required temporalis rotational flap closure, and two patients required rectus abdominus free tissue transfers. There was one perioperative death secondary to cardiac disease. There were no immediate wound complications. One patient developed a delayed partial trapezius flap failure successfully treated with a rectus abdominus flap. The trapezius rotational flap is a reliable means of closing complex lateral skull base defects with minimal morbidity.