Abstract
Introduction & Aims Microsurgical reconstruction in skull base surgery is not universally practiced. Current evidence suggests improved outcomes allowing more aggressive management of skull base pathology. We present our experience of free flaps in skull base reconstruction.Material & Methods 17 patients (10 male, 7 female, aged 30–72 years) required microsurgical reconstruction of skull base defects from 2004–2006. The anterior cranial fossa was involved in 10/17. Indications for surgery included malignancy (12/17) and benign neoplasia (3/17).Results 18 free flaps included 10 rectus abdominis, 5 radial forearm and 5 latissimus dorsi. Complications included one complete flap loss, one anastomotic revision, one CSF leak, one case of meningitis and one subdural empyema. There were no deaths.Conclusions We recommend free flap reconstruction for significant skull base defects involving both skull and dura. Important factors determining outcome include adequate pedicle length, flap thickness, use of fascia and controlled lumbar drainage.
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