Skull Base 2011; 21(6): 359-364
DOI: 10.1055/s-0031-1287676
ORIGINAL ARTICLE

© Thieme Medical Publishers

Review of Skull Base Reconstruction Using Locoregional Flaps and Free Flaps in Children and Adolescents

Tomoyuki Yano1 , Kentarou Tanaka1 , Seiji Kishimoto2 , Hideo Iida1 , Mutsumi Okazaki1
  • 1Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
  • 2Department of Head and Neck Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
Further Information

Publication History

Publication Date:
14 September 2011 (eFirst)

ABSTRACT

Tumors of the skull base are rare in children, and reconstruction in such patients has rarely been reported. We reviewed 16 cases of skull base reconstruction in patients under 18 years. The study group consisted of 10 boys and 6 girls, whose ages ranged from 2 to 17 years. Of the 16 cases, eight tumors were benign and eight were malignant. Defects were anterior in six cases, lateral in eight cases, and anterolateral in two cases. Reconstruction was performed with locoregional flaps in 11 cases and with free flaps in 5 cases. No significant difference was found between locoregional flaps and free flaps in total operative time, intraoperative blood loss, or postoperative hospital stay. However, in some cases, total operative time, reconstruction time, and blood loss increased to a degree unacceptable for pediatrics. Minor complications occurred in three patients and a major complication occurred in one case. Of four patients, three patients with postoperative complications had undergone chemoradiotherapy. Because of the physical weakness of pediatric patients, complicated reconstructive procedure should be avoided. We believe locoregional flaps will become the first choice for reconstruction. However, if patients have large, complex defects and have received radiotherapy, appropriate free flaps should be used to avoid postoperative complications.