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J Reconstr Microsurg 2003; 19(8): 561-566
DOI: 10.1055/s-2004-815643
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Secure Flap Fixation to Bony Tissue Using an Anchoring System in Skull-Base Surgery

Hideo Iida1 , Seiji Kishimoto2 , Tadashi Umeda1 , Yuiro Hata1
  • 1Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Tokyo, Japan
  • 2Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
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Publication History

Publication Date:
14 January 2004 (online)

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ABSTRACT

The reconstruction of extensive skull-base defects using flap transfer decreases crucial postoperative complications. However, flap fixation to bony tissue is often difficult, especially if there is no soft tissue to pass sutures through, and unsteady flap fixation causes dead space formation or displacement of the transferred flap due to gravity. The authors used an anchoring system for secure flap fixation in seven cases with difficult flap fixation, using the conventional suturing technique. Anchors were inserted at strategic points in the bony tissue, and secure flap fixation was achieved in all cases. Postoperative CT scans showed no dead space formation, and major postoperative complications were not observed.

The anchoring system can be buried in bony tissue with a thickness of more than 4 mm, and it enables reliable flap fixation and dead space obliteration. Although the cost is relatively high, the procedure is simple and lowers the risk of crucial postoperative complications in skull-base surgery.

KEYWORDS

Anchoring system - flap fixation - skull-base reconstruction

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