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Reconstruction for Skull Base Defect Using Fat-Containing Perifascial Areolar Tissue

 Choi, Woo Young  ;  Sung, Ki Wook  ;  Kim, Young Seok  ;  Hong, Jong Won  ;  Roh, Tai Suk  ;  Lew, Dae Hyun  ;  Chang, Jong Hee  ;  Lee, Kyu Sung 
 ANNALS OF PLASTIC SURGERY, Vol.78(6) : 673-679, 2017 
Journal Title
Issue Date
Adipose Tissue/transplantation* ; Adult ; Chordoma/surgery* ; Fascia/transplantation* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Meningioma/surgery* ; Middle Aged ; Neuroma, Acoustic/surgery* ; Reconstructive Surgical Procedures/methods* ; Skull Base/injuries ; Skull Base/surgery* ; Skull Base Neoplasms/surgery* ; Treatment Outcome
Skull base reconstruction is a challenging task. The method depends on the anatomical complexity and size of the defect. We obtained tissue by harvesting fat-containing perifascial areolar tissue (PAT) for reconstruction of limited skull base defects and volume augmentation. We demonstrated the effective option for reconstruction of limited skull base defects and volume augmentation. From October 2013 to November 2015, 5 patients underwent operations using fat-containing PAT to fill the defect in skull base and/or perform volume replacement in the forehead. Perifascial areolar tissue with 5- to 10-mm fat thickness was harvested from the inguinal region. The fat-containing PAT was grafted to the defect contacting the vascularized wound bed. Patients were followed up in terms of their clinical symptoms and postoperative magnetic resonance imaging findings. Four patients were treated using fat-containing PAT after tumor resection. One patient was treated for a posttraumatic forehead depression deformity. The fat-containing PAT included 5- to 9-mm fat thickness in all cases. The mean size of grafted PAT was 65.6 cm (28-140 cm). The mean follow-up period was 18.6 months (12-31 months). There was no notable complication. There was no donor site morbidity. We can harvest PAT with fat easily and obtain the sufficient volume to treat the defect. It also could be used with other reconstructive method, such as a free flap or a regional flap to fill the left dead space. Therefore, fat-containing PAT could be additional options to reconstruction of skull base defect.
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1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Seok(김영석) ORCID logo https://orcid.org/0000-0002-0981-2107
Sung, Ki Wook(성기욱)
Lew, Dae Hyun(유대현)
Lee, Kyu Sung(이규성)
Chang, Jong Hee(장종희)
Hong, Jong Won(홍종원) ORCID logo https://orcid.org/0000-0002-7762-0940
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