Salphingopharyngeus Muscle Flap: A Novel Pedicled Reconstructive Flap
Objective: Improvements in the efficacy of extended endonasal approaches to resect skull base pathologies, in turn, have created the need for new reconstructive alternatives. Hereby, we describe a novel pedicled myo- mucosal flap that allows the reconstruction of defects in the lower clivus and craniovertebral junction, or to cover the paraclival segment of the internal carotid artery.
Study Design: Anatomic description. Technical report. Feasibility. Methods: We describe a myomucosal flap with a cephalic pedicle based on the salpingopharyngeus muscle (SPM) and its vessels, the DICLE flap. Subsequently, using a cadaveric model, we harvested the flap and explored its potential for the reconstruction of inferior clival and craniovertebral junction defects or to cover the petrous and paraclival segments of the internal carotid artery.
Results: Our study confirmed the feasibility of harvesting and transposing the DICLE flap for the reconstruction of inferior clival and craniovertebral junction defects or to cover the petrous and clival segments of the internal carotid artery.
Conclusions: The DICLE flap is a feasible reconstructive alternative for the reconstruction of select defects of the most posterior and inferior aspects of the ventral skull base. Key words: Endoscopy, pedicled flap, skull base surgery/complications, reconstruction