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European Archives of Oto-Rhino-Laryngology

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Open Access 01-12-2019 | Head and Neck

Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection

Authors: Piotr Trojanowski, Marcin Szymański, Agnieszka Trojanowska, Adrian Andrzejczak, Dariusz Szczepanek, Janusz Klatka

Published in: European Archives of Oto-Rhino-Laryngology | Issue 12/2019

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Title: Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection
Authors: Piotr Trojanowski
Marcin Szymański
Agnieszka Trojanowska
Adrian Andrzejczak
Dariusz Szczepanek
Janusz Klatka
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 12/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05627-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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