Free tissue transfer and local flap complications in anterior and anterolateral skull base surgery

Jason A. Heth, Gerry F. Funk, Lucy H. Karnell, Timothy M. McCulloch, Vincent C. Traynelis, Jeffrey A. Nerad, Russell B. Smith, Scott M. Graham, Henry T. Hoffman

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Background. Advances in reconstructive techniques over the past two decades have allowed the resection of more extensive skull base tumors than had previously been possible. Despite this progress, complications related to these cases remain a concern. Methods. Univariate and multivariate analyses were used to determine the relationship of host, tumor, defect, treatment, and reconstructive variables to wound and systemic complications after anterior and anterolateral skull base resections. The study included 67 patients receiving local flap (LF) or free tissue transfer (FTT) reconstructions during an 8-year period. Results. Overall, 28% of patients had a major wound complication, and 19% had a major systemic complication. LF and FTT flaps had similar rates of wound complications. LF reconstructions were associated with late wound breakdown problems, and FTT flap complications were primarily acute surgery-related problems. Conclusions. The surgical reconstruction of skull base defects should be planned on the basis of the ability of the technique to attain safe closure and maintain integrity after radiation therapy.

Original languageEnglish (US)
Pages (from-to)901-912
Number of pages12
JournalHead and Neck
Issue number10
StatePublished - Oct 1 2002


  • Anterior skull base surgery
  • Free tissue transfer
  • Pericranial flaps
  • Surgical complications

ASJC Scopus subject areas

  • Otorhinolaryngology

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