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Background: Skull base reconstruction is challenging due to its proximity to important anatomical structures. This report evaluates the use of perforator flaps for reconstruction of skull base defects after advanced recurrent tumor resection.
Methods: Fourteen free perforator flaps were transferred to reconstruct skull base defects in 14 consecutive patients, from October 2004 to May 2011. All patients had advanced recurrent neoplasms that were previously treated with either radiation therapy or surgery. The surgical defects were reconstructed using various perforator flaps mainly the deep inferior epigastric artery perforator flaps, anterolateral thigh (ALT) flaps, or thoracodorsal artery perforator flaps. The outcomes following reconstruction and associated complications were evaluated.
Results: The overall free flap success rate was 93% (13/14). One ALT flap was lost. Three patients (20%) had a cerebrospinal fluid fistula, and two of them developed meningitis. No complications were observed at the donor site.
Conclusions: The use of perforator flaps may be a viable option for reconstruction of skull base defects after the resection of advanced recurrent tumor.
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http://dx.doi.org/10.1002/micr.22271 | DOI Listing |
J Surg Case Rep
September 2025
Department of Plastic Surgery and Hand Surgery, HOCH, Kantonsspital St Gallen, Rorschacherstrasse 95, 9007 St Gallen, Switzerland.
Vascularized reconstruction of bone defects in the foot after osteomyelitis is a complex procedure that requires an orthoplastic collaboration. This case demonstrates the successful use of a free osteocutaneous fibula flap with a perforator-based skin island to reconstruct the medial midfoot following a late-onset infection after fusion for osteonecrosis. A 63-year-old woman presented after osteonecrosis and failed surgeries, including talonavicular and naviculocuneiform arthrodesis complicated by infection.
View Article and Find Full Text PDFAnn Plast Surg
September 2025
From the Department of Plastic Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN.
Background: Loss of breast sensation following mastectomy and reconstruction significantly impacts quality of life, influencing body image, intimacy, and overall emotional well-being. Despite advances in reconstructive techniques, sensory outcomes remain inconsistent, limiting broader clinical adoption of reinnervation strategies. This educational review synthesizes the current scope of sensory restoration in breast reconstruction, examining approaches to reinnervation, sensory outcome measures, and management of patient expectations.
View Article and Find Full Text PDFMicrosurgery
September 2025
Department of Otorhinolaryngology - Head and Neck Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Objective: Reconstruction after partial laryngectomy poses challenges in preserving voice, swallowing, and airway patency. Tailored laryngeal free-flap reconstructions using multiple chimeric perforator flaps aim to maximize functional preservation of the larynx and facilitate swallowing rehabilitation by enhancing larynx mobility.
Methods: Various compartmental laryngeal reconstructions using chimeric free flaps were performed on seven male patients (aged 40-82) with laryngeal malignancies following open partial laryngectomy.
Int J Surg Protoc
December 2025
Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.
Background: End-to-end anastomosis to the internal mammary artery (IMA) is the current standard anastomosis technique for women undergoing autologous breast reconstruction with deep inferior epigastric perforator (DIEP) flap. This approach fails to preserve the length of the IMA, compromising its availability for cardiac surgery use in women who develop coronary heart disease. A viable alternative may be end-to-side anastomosis, but data on its feasibility is currently lacking.
View Article and Find Full Text PDFJ Plast Reconstr Aesthet Surg
August 2025
University College London, London, United Kingdom; Royal Free London NHS Foundation Trust, London, United Kingdom.
Background: In the deep inferior epigastric perforator (DIEP) flap breast reconstruction, fat necrosis is a common and distressing complication for patients. While venous outflow augmentation using the superficial inferior epigastric vein (SIEV) has been suggested to improve some perfusion-related outcomes, its effect on fat necrosis remains insufficiently substantiated.
Methods: A retrospective review was conducted of unilateral, unipedicled DIEP flap breast reconstructions performed between 2012 and 2023 at a tertiary centre in London, United Kingdom.