Temporoparietal Fascia Flap Reconstruction for Lateral Skull Base Tumors

Abstract

Objective: 1) Determine the efficacy of the temporoparietal fascia flap (TPFF) in preventing cerebrospinal fluid (CSF) leaks during skull base reconstruction for lateral skull base tumors. 2) Learn which factors lead to success of the TPFF. Method: A retrospective chart review was conduced of lateral skull base resections from 2005 to 2010 at a tertiary academic hospital. Patients were divided into TPFF versus non-TPFF groups. Data on tumor size, intradural extension, and presence of postoperative CSF leak were recorded and compared between groups. Results: A total of 62 patients underwent lateral skull base resection and were available for review. Sixteen patients had a TPFF reconstruction and 46 patients had other forms of reconstruction. The rates of CSF leak in TPFF versus non-TPFF groups were 6% and 11%, respectively. Patients with TPFF reconstruction were more likely to have large tumors (25% vs 9%) and to undergo intradural surgical dissection (25% versus 13%). The TPFF group had a higher number of paragangliomas (93% vs 32%) and the non-TPFF group had a higher rate of squamous cell carcinoma and meningioma (19% and 10%, versus 0%). Conclusion: TPFF reconstruction of lateral skull base defects is effective in preventing postoperative CSF leaks. Since the procedure has low morbidity, it should be considered in all lateral skull base defects at risk for CSF leaks, especially for patients with large tumors or intradural involvement.