Reconstruction of infected skull base defects utilizing free tissue transfer

Hamid R. Djalilian, Markus Gapany, Samuel C. Levine

Research output: Contribution to journalArticlepeer-review


The aim of this presentation is to share our experience in managing large skull base defects complicated by complex infections with microvascular free tissue transfer in three patients. The first patient developed an infection, CSF leak and meningitis following a translabyrinthine resection of an acoustic neuroma. The second patient had a history of a gunshot wound to the temporal bone, with a large defect and an infected cholesteatoma causing several episodes of meningitis. The third patient developed CSF leak and meningitis following temporal bone resection for adenocarcinoma invading the labyrinthine segment of the facial nerve. In all cases prior attempts of closure with fat grafts or regional flaps had failed. Rectus abdominis myofascial free flap was used in all cases after debridement of the infected cavities. Successful control of CSF leak, local infection, and meningitis were achieved within a week in all cases. In our experience, microvascular free tissue provides the necessary bulk of viable, wellvascularized tissue, which not only assures a mechanical seal, but also helps clear the local infection.

Original languageEnglish (US)
Pages (from-to)9
Number of pages1
JournalSkull Base Surgery
Issue numberSUPPL. 1
StatePublished - 1999


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