Reconstruction of lateral skull base defects with the trapezius myocutaneous flap: a description of two cases
Introduction: Cancer involving the temporal bone may pose a difficult problem in both an oncologic and a reconstructive standpoint. These cancers are typically aggressive as well as locally advanced which require wide resections combined with parotidectomy and / or neck dissection resulting in exten...
| Main Authors: | , , |
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| Format: | Conference or Workshop Item |
| Language: | English English English |
| Published: |
2006
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/16995/ http://irep.iium.edu.my/16995/1/Dr_Raja4.IFNOS.Prague.pdf http://irep.iium.edu.my/16995/4/a_foniatrie.pdf http://irep.iium.edu.my/16995/5/Lateral_Skull_Recons.IFHNOS.2006.pdf |
| Summary: | Introduction: Cancer involving the temporal bone may pose a difficult problem in both an oncologic and a reconstructive standpoint. These cancers are typically aggressive as well as locally advanced which require wide resections combined with parotidectomy and / or neck dissection resulting in extensive soft tissue and skin defects. Reconstruction of the surgical defects in temporal bone resection may vary from simple closure of the external ear canal to a complex flap coverage depending on the extent of surgical resection. The principles in reconstruction of lateral skull base defects are to maintain the symmetry, cosmesis of the lateral skull structures, to achieve dead-space obliteration and finally to have a quality vascularized tissue which able to withstand adjuvant radiotherapy treatment.
Material and methods:
We describe two of our patients with different type of cancer involving the temporal bone undergoing extensive resection of the lateral skull base. The local defects were reconstructed with two different type of pedicled trapezius myocutaneous flap that are the lateral and lower trapezius flap. The techniques used in reconstruction of the defects are addressed.
Results: In both patients, the surgical reconstruction showed good symmetry and cosmesis of the lateral skull base. Especially in the second case, the flap survived the adjuvant radiotherapy. The functional recoveries in both cases after surgery were excellent.
Conclusions: Lateral skull base cancer is a rare clinical entity that creates challenge in head and neck surgery not only in cancer extirpation but also the reconstruction of the surgical defects. The trapezius myocutaneous flap that requires less skill to harvest can offers a reliable reconstructive option for the lateral skull base defects. |
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