두개저 종양 절제술 후 유리 피판술을 이용한 재건

Use of the Free Flaps for Cranial Base Reconstruction after Tumor Ablation

In the past, cranial base reconstruction after tumor ablation involved prostheses or local and pedicled flaps, often creating a functionally unappealing outcome. The complications that arose in the case of reconstructive failure were the potentially life-threatening, and a failed reconstruction deferred the initiation of adjuvant therapy such as a radiation therapy. With the advent of microvascular surgical techniques, free flaps have become an attractive alternative in the reconstruction of cranial base defects. Free flaps were highly vascularized and, thus, could be used in an irradiated site or in patients who planned to receive adjuvant therapy. The vascularity of free flaps enhanced the potential for delivery of chemotherapeutic agents to the resected area. Furthermore, its large size and freedom for insetting facilitated obliteration of dead space and separation of the oropharynx from the meninges. Compared with local or pedicled flaps, free flaps were more successful and were associated with fewer complications. In conclusion, free flaps were safe and effective in skull base reconstruction and provided an opportunity for wide surgical excision of dura and skull base structures to obtain tumor-free margins.