PC31. Splenius Capitis Muscle Flap for Treatment of Chiari I Malformation Decompression Reconstruction - A Case Series

Abstract

PURPOSE: The purpose of this study is to report outcomes of patients who have undergone the splenius capitis muscle flap for posterior neck space obliteration after Chiari I malformation decompression procedures. METHODS: The Institutional Review Board exemption was obtained. Patients who underwent Chiari I malformation decompression with splenius capitis muscle flap reconstruction were evaluated. Patient demographics, prior surgical intervention; variations in surgical techniques, as well intraoperative and postoperative complications were analyzed between the years of 2009 and 2022. RESULTS: A total of 22 patients who had undergone Chiari I malformation decompression with splenius capitis muscle flap reconstruction were identified. Age ranged between 16 and 59, with 19 (86.4%) females and 3 (13.6%) males. Six complications were identified, with 2 patients experiencing a CSF leak, 2 with superficial wound infection, and 2 with incisional dehiscence. The CSF leak patients were treated with a lumbar drain placement and healed without compromising the reconstruction. Likewise the superficial wound dehiscence and infection did not compromise muscle coverage with successful healing outcomes. Finally, none of the patients experienced donor site functional morbidity. CONCLUSION: The splenius capitis flap is a safe and effective muscle flap for posterior neck space obliteration in Chiari I malformation decompression procedures. With six patients experiencing surgical site dehiscence/infection and CSF leak, all patients healed with minimal intervention and no reconstruction compromise. [1] Elsahy NI, Achecar FA. Use of the splenius capitis muscle flap for reconstruction of the posterior neck and skull in complicated Arnold-Chiari malformation. Plast Reconstr Surg. 1994;93(5):1082–1086.