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A free composite de‐epithelialized anterolateral thigh and the vastus lateralis muscle flap for the reconstruction of a large defect of the anterior skull base: A case report
Author(s) -
Lo KuoChuan,
Jeng ChuHsu,
Lin HwangChi,
Hsieh ChengHan,
Chen ChinLin
Publication year - 2011
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20919
Subject(s) - medicine , skull , microsurgery , surgery , anatomy , vastus lateralis muscle , cranial cavity , thigh , magnetic resonance imaging , free flap , radiology , skeletal muscle
Reconstruction of the anterior skull base is one of the greatest challenges for reconstructive surgeons. Sometimes, the defect is so large that a local flap is insufficient for the reconstruction. In this report, we present a case of malignant meningioma of the anterior skull base. The tumor was treated by surgical excision resulting in a large defect from the anterior skull base to the nasal cavity. The entire defect was within the cranial vault. The reconstruction was achieved using a free composite de‐epithelialized anterolateral thigh and the vastus lateralis muscle flap. Postoperative monitoring included hand Doppler and daily endoscopic inspection. This patient was satisfied with the cosmetic result. After 10 months, magnetic resonance imaging (MRI), performed to assess the flap, demonstrated that the volume of the de‐epithelialized skin paddle of the anterolateral thigh flap had not changed, and that there was no tissue atrophy between the patient's eyes that could have resulted in deformity. © 2011 Wiley‐Liss, Inc. Microsurgery, 2011.