Reconstruction of combined intra- extracranial defects by mycutaneuous free flap

Objective To evaluate the combined intra- extracranial defects reconstruction and to identify the reconstructive management principles that may assist in achieving successful multidisciplinary approaches.Methods The clinical records of 11 patients with recurrent tumors who required skull base reconstruction with mycutaneuous free flaps were reviewed retrospectively.The patients had undergone skull base surgery through multidisciplinary approaches with simultaneous reconstruction for the anterior and middle cranial fossa skull bases in 5 patients,and the posterior fossa in 1. Donor sites included the latissimus dorsi ( n =9) and pec toralis major muscle ( n =2 ).Results Reconstruction was performed as planned in all patients with a low incidence of complications.The necrosis of the flaps was not encountered.The postoperative recovery time was 7 to 15 days.Conclusions Mycutaneuous free flap transfer is a robust option in the repair of postoperative skull base penetrating defets.Latissimus dorsi mycutaneuous free flap is a well- vascularised flap with homogenous thickness,various types which could be harvested to cover any sizes and any locations of skull base defects. Key words: Penetrating tumor of skull base;  Defect;  Mycutaneuous free flap;  Reconstruction