Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2008-4-24
pubmed:abstractText
Surgical ablation for oncologic disease requiring skull base resection can result in both facial disfigurement and a complex wound defect with exposed orbital content, oral cavity, bone, and dural lining. Inadequate reconstruction can result in brain abscesses, meningitis, osteomyelitis, visual disturbances, speech impairment, and altered oral intake. This study assesses the functional outcomes of patients who undergo anterior and middle cranial fossa skull base reconstruction using microsurgical free tissue transfer techniques. Using a prospectively maintained database, a 10-year, single institution retrospective chart review was performed on patients who had surgery for anterior and middle cranial base tumor resections. The type of resection, reconstruction method, complication rate, and functional outcomes were reviewed. From 1992 to 2003, 70 patients (49 men, 21 women) with a mean age of 54 (age 6-78) underwent anterior and middle cranial skull base tumor resection and reconstruction. The patients were divided into the following groups: maxillectomy with orbital content preservation (n = 21), orbitomaxillectomy with palatal preservation (n = 26), and orbitomaxillectomy with palatal resection (n = 23). The average length of hospital stay was 12.6 days. The vertical rectus abdominis myocutaneous flap was used in the majority of cases to correct midface defects. Two flaps required emergent re-exploration; however, there were no flap failures. Early and late postoperative complications were investigated. Cerebrospinal fluid was observed infrequently (7%) and did not require additional surgical intervention. Intracranial abscesses were encountered rarely (1.4%). Patients who had maxillectomy with orbital preservation and reconstruction had minor ophthalmologic eyelid changes that occurred frequently. Patients who required palatal reconstruction had a normal or intelligible speech (93%) and unrestricted or soft diet (88%). Using a multidisciplinary surgical team approach, there is an increasing role for reconstruction of complex oncologic midface resection defects using microvascular surgical techniques. Early/late complications and functional problems after anterior cranial base resections are uncommon when free tissue transfer is used concomitantly.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
1536-3708
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
60
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
514-20
pubmed:meshHeading
pubmed-meshheading:18434825-Adolescent, pubmed-meshheading:18434825-Adult, pubmed-meshheading:18434825-Aged, pubmed-meshheading:18434825-Child, pubmed-meshheading:18434825-Cranial Fossa, Anterior, pubmed-meshheading:18434825-Cranial Fossa, Middle, pubmed-meshheading:18434825-Female, pubmed-meshheading:18434825-Humans, pubmed-meshheading:18434825-Male, pubmed-meshheading:18434825-Microcirculation, pubmed-meshheading:18434825-Microsurgery, pubmed-meshheading:18434825-Middle Aged, pubmed-meshheading:18434825-Postoperative Complications, pubmed-meshheading:18434825-Reconstructive Surgical Procedures, pubmed-meshheading:18434825-Retrospective Studies, pubmed-meshheading:18434825-Skull Base, pubmed-meshheading:18434825-Skull Base Neoplasms, pubmed-meshheading:18434825-Surgical Flaps, pubmed-meshheading:18434825-Treatment Outcome, pubmed-meshheading:18434825-Wounds and Injuries
pubmed:year
2008
pubmed:articleTitle
Anterior and middle cranial fossa skull base reconstruction using microvascular free tissue techniques: surgical complications and functional outcomes.
pubmed:affiliation
Tulane Health Sciences Center, New Orleans, LA, USA.
pubmed:publicationType
Journal Article