Reconstruction Outcomes Following Lateral Skull Base Resection

Nicholas J Thompson; Joseph P Roche; Nathan M Schularick; Kristi E Chang; Marlan R Hansen

doi:10.1097/mao.0000000000001279

Back

Reconstruction Outcomes Following Lateral Skull Base Resection

Journal article

Peer reviewed

Reconstruction Outcomes Following Lateral Skull Base Resection

Nicholas J Thompson, Joseph P Roche, Nathan M Schularick, Kristi E Chang and Marlan R Hansen

Otology & neurotology, Vol.38(2), pp.264-271

02/2017

DOI: 10.1097/mao.0000000000001279

PMID: 27832006

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/8547891View

Open Access

Abstract

Compare reconstruction outcomes for various lateral skull base closure techniques. Retrospective medical records review. University-based tertiary referral center. Patients who underwent resections of tumors involving the lateral skull base requiring reconstruction beyond primary closure. Reconstructive techniques, from rotational flaps to free tissue transfer. Outcome data including wound complications, cerebrospinal fluid (CSF) leakage, and need for surgical revision were tabulated. Eighty-six patients underwent lateral skull base tumor resection and reconstruction. Procedures were primarily lateral temporal bone resections but also included subtotal temporal bone, total temporal bone, and infratemporal fossa resections. Cutaneous malignancy was the most common resection indication (83%) and the temporalis rotational flap was the most commonly employed reconstructive option (30%). When free tissue transfer techniques were used, the radial forearm, anterolateral thigh, and latissimus dorsi were the most frequent donor sites. Patients with T2 disease were more likely to undergo temporalis flaps, whereas patients with T4 disease were more likely to undergo free flap reconstruction. Major complications were uncommon (∼8%), the most frequent being stroke (∼3%). The postoperative wound complication rate was approximately 45%. The majority involved minor dehiscences and were managed conservatively. Patients with T4 disease were more likely to have wound complications (p < 0.05). Radial forearm free flaps were less likely to have wound complications when compared with other reconstruction techniques (p < 0.05). Many factors go into planning lateral skull base reconstruction. Free flaps were more often used for T4 disease. Radial forearm free flaps tended to have lower wound complication rates when compared with other techniques.

Surgical Flaps

Humans

Middle Aged

Orthopedic Procedures - methods

Reconstructive Surgical Procedures - methods

Postoperative Complications - surgery

Male

Treatment Outcome

Skull Base - surgery

Adult

Female

Aged

Retrospective Studies

Skull Base Neoplasms - surgery

Details

Title: Subtitle: Reconstruction Outcomes Following Lateral Skull Base Resection
Creators: Nicholas J Thompson - Department of Otolaryngology-Head and Neck Surgery, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa †Current addresses: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina ‡Department of Surgery/Division of Otolaryngology, School of Medicine and Public Health, The University of Wisconsin-Madison, Madison, Wisconsin
Joseph P Roche
Nathan M Schularick
Kristi E Chang
Marlan R Hansen
Resource Type: Journal article
Publication Details: Otology & neurotology, Vol.38(2), pp.264-271
DOI: 10.1097/mao.0000000000001279
PMID: 27832006
NLM abbreviation: Otol Neurotol
ISSN: 1531-7129
eISSN: 1537-4505
Publisher: United States
Language: English
Date published: 02/2017
Academic Unit: Molecular Physiology and Biophysics; Radiation Oncology; Neurosurgery; Otolaryngology
Record Identifier: 9984007169802771

Metrics

22 Record Views

18 Times Cited - Web of Science