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Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

BACKGROUND: Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We pro...

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Autores principales: Kwon, Seung Gee, Kim, Yong Oock, Rah, Dong Kyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Plastic and Reconstructive Surgeons 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408280/
https://www.ncbi.nlm.nih.gov/pubmed/22872838
http://dx.doi.org/10.5999/aps.2012.39.4.345
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author Kwon, Seung Gee
Kim, Yong Oock
Rah, Dong Kyun
author_facet Kwon, Seung Gee
Kim, Yong Oock
Rah, Dong Kyun
author_sort Kwon, Seung Gee
collection PubMed
description BACKGROUND: Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction. METHODS: Between April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability. RESULTS: The mean follow-up period was 11.8 months and the mean operation time for reconstruction was 8.4±3.36 hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures. CONCLUSIONS: The reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.
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spelling pubmed-34082802012-08-07 Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft Kwon, Seung Gee Kim, Yong Oock Rah, Dong Kyun Arch Plast Surg Original Article BACKGROUND: Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction. METHODS: Between April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability. RESULTS: The mean follow-up period was 11.8 months and the mean operation time for reconstruction was 8.4±3.36 hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures. CONCLUSIONS: The reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer. The Korean Society of Plastic and Reconstructive Surgeons 2012-07 2012-07-13 /pmc/articles/PMC3408280/ /pubmed/22872838 http://dx.doi.org/10.5999/aps.2012.39.4.345 Text en Copyright © 2012 The Korean Society of Plastic and Reconstructive Surgeons http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kwon, Seung Gee
Kim, Yong Oock
Rah, Dong Kyun
Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft
title Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft
title_full Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft
title_fullStr Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft
title_full_unstemmed Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft
title_short Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft
title_sort anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408280/
https://www.ncbi.nlm.nih.gov/pubmed/22872838
http://dx.doi.org/10.5999/aps.2012.39.4.345
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