FREE-FLAP RECONSTRUCTION OF TUMORS INVOLVING THE CRANIAL BASE

The authors describe their experience in treating 24 patients who unde rwent resection of tumors involving anterior, middle or posterior cran ial fossa with immediate reconstruction. All were reconstructed with f ree flaps, 15 rectus abdominis, 4 radial forearm, 3 latissimus dorsi, 2 great omentum, and one scapular flap. There was one latissimus dorsi flap loss due to arterial thrombosis in a heavily irradiated patient. Three Patients presented with a temporary cerebrospinal fluid leak, o ne of them with meningitis which resolved after intravenous antibiotic s and continuous lumbar drainage. Fifteen patients were followed (mean 2 years). Five died of recurrence. Four presented local recurrence. S ix patients are alive with no signs of recurrence.Free flaps, especial ly the rectus abdominis flap and the latissimus dorsi, are versatile f laps and may be easily positioned to cover several structures or anato mical surfaces. (C) Wiley-Liss, Inc.