Reconstruction of Lateral Skull Base Defects using the Cervicopectoral Flap

The challenges inherent in excision of tumors of the lateral skull base are well documented and numerous techniques have evolved to address these. The approach to reconstruction of the resulting defects however, while just as challenging, is not as frequently discussed in the literature.

There are a variety of local, pedicled/regional, and free flaps that may be employed to achieve adequate reconstruction, all of which ideally should be hardy, reliable, and cosmetically acceptable. The cervicopectoral rotation flap may be employed as a fasciocutaneous or myofasciocutaneous flap to fulfill the aforementioned criteria.

This flap's arc of rotation is well suited to filling defects in the lateral skull base and blends seamlessly with the incision for the primary lesion, as well as the neck dissection. The utility of the latter is especially poignant when the surgeon performing the excision and neck dissection, performs the reconstruction as well and can therefore excise tumor and harvest one's flap through the same extended incision. The color of the cervicopectoral skin is closer to the native hue of the lateral skull base than that of most commonly used regional and free flap methods of reconstruction. The overall result is a reliable reconstruction, with shorter surgical time and more attractive cosmesis.

This study elucidates our institution's experience with cervicopectoral flap technique.