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J Reconstr Microsurg 2013; 29(03): 195-198
DOI: 10.1055/s-0032-1333315
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Closure of Large, Complex Defects after Oncologic Neurosurgery with a Free Myoperitoneal Flap

Louis de Weerd
1   Department of Plastic Surgery and Hand Surgery, University Hospital North Norway, Tromsø, Norway
,
Roar Kloster
2   Department of Neurosurgery, University Hospital North Norway, Tromsø, Norway
,
Clemens Walter
1   Department of Plastic Surgery and Hand Surgery, University Hospital North Norway, Tromsø, Norway
› Author Affiliations
Further Information

Publication History

16 May 2012

22 October 2012

Publication Date:
09 January 2013 (online)

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Abstract

Extensive and complex defects after neurosurgical oncologic resections including dura are a challenge, as watertight closure is of paramount importance. This article illustrates the usefulness of a free myoperitoneal flap in closure of such a defect when located at the skull base or cranium. The vascularized peritoneum appears to be an excellent biological replacement for the dura and the well-vascularized muscle promotes wound healing and obliterates dead space.

Keywords

musculoperitoneal flap - dura:skull base - cerebrospinal fluid leakage - esthesioneuroblastoma

Note

Presented as a poster at the 6th Congress of the World Society for Reconstructive Microsurgery 29 June–2 July 2011, Helsinki, Finland.


 

  • References

  • 1 Neligan PC, Boyd JB. Reconstruction of the cranial base defect. Clin Plast Surg 1995; 22: 71-77
    PubMedGoogle Scholar
  • 2 Robson MC, Zachary LS, Schmidt DR, Faibisoff B, Hekmatpanah J. Reconstruction of large cranial defects in the presence of heavy radiation damage and infection utilizing tissue transferred by microvascular anastomoses. Plast Reconstr Surg 1989; 83: 438-442
    CrossrefPubMedGoogle Scholar
  • 3 Chang DW, Robb GL. Microvascular reconstruction of the skull base. Semin Surg Oncol 2000; 19: 211-217
    CrossrefPubMedGoogle Scholar
  • 4 Wang HT, Erdmann D, Olbrich KC, Friedman AH, Levin LS, Zenn MR. Free flap reconstruction of the scalp and calvaria of major neurosurgical resections in cancer patients: lessons learned closing large, difficult wounds of the dura and skull. Plast Reconstr Surg 2007; 119: 865-872
    CrossrefPubMedGoogle Scholar
  • 5 Mixter RC, Mayfield K, Dibbell DG, Rao VK. Intraoral reconstruction with a microvascular peritoneal flap. Plast Reconstr Surg 1991; 88: 452-457
    PubMedGoogle Scholar
  • 6 Konerding M, Gaumann A, Shumsky A, Schlenger K, Hockel M. The vascular anatomy of the anterior abdominal wall with special reference to the transversus andrectus abdominis musculoperitoneal (TRAMP) composite flap for vaginal reconstruction. Plast Reconstr Surg 1997; 99: 705-710
    PubMedGoogle Scholar
  • 7 Jinming Z, Xiaoxuan C, Jieren P, Shujuan P. The rectus abdominis musculoperitoneal (RAMP) flap for the reconstruction of complicated pharyngoesophageal defects. Br J Plast Surg 2005; 58: 608-613
    CrossrefPubMedGoogle Scholar
  • 8 Amin A, Rifaat M, Civantos F, Weed D, Abu-Sedira M, Bassiouny M. Free anterolateral thigh flap for reconstruction of major craniofacial defects. J Reconstr Microsurg 2006; 22: 97-104
    Google Scholar
  • 9 Calderon W, Chang N, Mathes SJ. Comparison of the effect of bacterial inoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg 1986; 77: 785-794
    CrossrefPubMedGoogle Scholar
  • 10 Arnez ZM, Bajec J, Bardsley AF, Scamp T, Webster MH. Experience with 50 free TRAM flap breast reconstructions. Plast Reconstr Surg 1991; 87: 470-478 , discussion 479–482
    CrossrefPubMedGoogle Scholar
  • 11 Beals SP, Joganic EF, Holcombe TC, Spetzler RF. Secondary craniofacial problems following skull base surgery. Clin Plast Surg 1997; 24: 565-581
    PubMedGoogle Scholar