Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Evaluation of the utility of the free anterolateral thigh flap reconstruction of the defects resulting from radical temporal bone resection in the management of lateral skull base malignancies in a single institution.
An analysis of 17 en bloc subtotal petrosectomies for removal of malignant tumours was performed. There were 12 squamous cell carcinomas, 4 basal cell carcinomas and 1 adenoid cystic carcinoma. The tumours were staged with the University of Pittsburgh TNM system. In all patients, the lateral temporal bone with the preservation of the petrous apex and carotid artery was performed. All patients had parotid gland resection. The post-resection defect was reconstructed with an ALT free flap.
Tumour radical resection and defect reconstruction with an ALT flap was achieved in all patients without intraoperative complications. The transplants were harvested as fasciocutaneous flaps, 11 perfused by musculocutaneous and 6 by septocutaneous perforators. The ALT flaps had a mean pedicle length of 8 cm (6–12 cm), and the flap size ranged between 6 × 15 cm and 15 × 30 cm. The flaps were supplied by nine facial, five occipital and three maxillary arteries. Recipient-site veins included eight internal jugular, seven facial, one retromandibular and one external jugular vein. All arterial pedicles were anastomosed in an end-to-end manner. The veins were anastomosed with interrupted sutures and in 11 cases with Synovis-Coupler® devices. All the flap transfers were performed successfully. Three patients experienced postoperative complications.
The ALT flap proved to be effective for covering large temporal skull base defects resulting from the radical removal of temporal bone malignancies. The functional and cosmetic results were acceptable with a low complication rate.
Moffat DA, Wagstaff SA (2003) Squamous cell carcinoma of the temporal bone. Curr Opin Otolaryngol Head Neck Surg 11:107–111 CrossRef
Moody SA, Hirsch BE, Myers EN (2000) Squamous cell carcinoma of the external auditory canal: an evaluation of a staging system. Am J Otol 21:582–588
Nyrop M, Grontved A (2002) Cancer of the external auditory canal. Arch Otolaryngol Head Neck Surg 128:834–837 CrossRef
Yeung P, Bridger A, Smee R, Baldwin M, Bridger GP (2002) Malignancies of the external auditory canal and temporal bone: a review. ANZ J Surg 72:114–120 CrossRef
Beyea JA, Moberly AC (2015) Squamous cell carcinoma of the temporal bone. Otolaryngol Clin North Am 48:281–292. https://doi.org/10.1016/j.otc.2014.12.003 CrossRef
Wierzbicka M, Niemczyk K, Bruzgielewicz A et al (2017) Multicenter experiences in temporal bone cancer surgery based on 89 cases. PLoS ONE 1:12. https://doi.org/10.1371/journal.pone.0169399
Marzo SJ, Benscoter B, Leonetti JP (2011) Contemporary options for lateral skull base reconstruction following tumor extirpation. Curr Opin Otolaryngol Head Neck Surg 19:330–334. https://doi.org/10.1097/MOO.0b013e328349a10c CrossRef
Moncrieff MD, Hamilton SA, Lamberty GH et al (2007) Reconstructive options after temporal bone resection for squamous cell carcinoma. J Plast Reconstr Aesthet Surg 60:607–614. https://doi.org/10.1016/j.bjps.2006.11.005 CrossRef
Thompson NJ, Roche JP, Schularick NM, Chang KE, Hansen MR (2017) Reconstruction outcomes following lateral skull base resection. Otol Neurotol 38:264–271. https://doi.org/10.1097/MAO.0000000000001279 CrossRef
Oranges CM, Ling B, Tremp M, Wettstein R, Kalbermatten DF, Schaefer DJ (2018) Comparison of anterolateral thigh and radial forearm free flaps in head and neck reconstruction in vivo 32:893–897. https://doi.org/10.21873/invivo.112325
Hanasono MM, Sacks JM, Goel N, Ayad M, Skoracki RJ (2009) The anterolateral thigh free flap for skull base reconstruction. Otolar-yngol Head Neck Surg 140:855–860 CrossRef
Malata CM, Tehrani H, Kumiponjera D, Hardy DG, Moffat DA (2006) Use of anterolateral thigh and lateral arm fasciocutaneous free flaps in lateral skull base reconstruction. Ann Plast Surg 57:169–175 CrossRef
Knuf KM, Maani CV, Cummings AK (2018) Clinical agreement in the American Society of Anesthesiologists physical status classification. Perioper Med (Lond) 7:14 CrossRef
Imola MJ, Sciarretta V, Schramm VL (2003) Skull base reconstruction. Curr Opin Otolaryngol Head Neck Surg 11:282–290 CrossRef
Thurnher D, Novak CB, Neligan PC, Gullane PJ (2007) Reconstruction of lateral skull base defects after tumor ablation. Skull Base 17:79–88 CrossRef
Mehra S, Luc G. Morris LG et al. Outcomes of temporal bone resection for locally advanced parotid cancer. Skull Base 2011;21:389–96. Doi: 10.1055/s-0031–1287682.
O'Connell DA, Teng MS, Mendez E, Futran ND (2011) Microvascular free tissue transfer in the reconstruction of scalp and lateral temporal bone defects. Craniomaxillofac Trauma Reconstr 4:179–188 CrossRef
Arnaoutakis D, Kadakia S, Abraham M, Lee T, Ducic Y (2017) Locoregional and microvascular free tissue reconstruction of the lateral skull base. Semin Plast Surg 31:197–202 CrossRef
Khadakban D, Kudpaje A, Thankappan K et al (2016) Reconstructive indications of anterolateral thigh free flaps in head and neck reconstruction craniomaxillofac. Trauma Reconstr. 9:40–45. https://doi.org/10.1055/s-0035-1558455
Patel NS, Modest MC, Brobst TD et al (2016) Surgical management of lateral skull base defects. Laryngoscope 126:1911–1917 CrossRef
Song YG, Chen GZ, Song YL (1984) The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 37:149–159 CrossRef
Eckardt A, Meyer A, Laas U, Hausamen JE (2007) Reconstruction of defects in the head and neck with free flaps: 20 years experience. Br J Oral Maxillofac Surg 45:11–15 CrossRef
Pohlenz P, Klatt J, Schon G, Blessmann M, Li L, Schmelzle R (2012) Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps. Int J Oral Maxillofac Surg 41:739–743. https://doi.org/10.1016/j.ijom.2012.02.012 CrossRef
Beausang ES, Ang EE, Lipa JE et al (2003) Microvascular free tissue transfer in elderly patients: the Toronto experience. Head Neck 25:549–553 CrossRef
Ciolek PJ, Clancy K, Michael A, Fritz MA, Lamarre ED (2017) Perioperative cardiac complications in patients undergoing head and neck free flap reconstruction. Am J Otolaryngol 38:433–437 CrossRef
Scaglioni M-T, Giovanoli P, Scaglioni MF, Yang JCS (2019) Microsurgical head and neck reconstruction in patients with coronary artery disease: A perioperative assessment algorithm. Microsurgery. https://doi.org/10.1002/micr.30429
- Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection
- Springer Berlin Heidelberg
European Archives of Oto-Rhino-Laryngology
and Head & Neck
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
Neu im Fachgebiet HNO
Mail Icon II