Staged Intracranial Free Tissue Transfer and Cranioplasty for a Refractory Nasal-cranial Base Fistula.

Autor:	Emanuels AF; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, Minn., Cherukuri S; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, Minn., Van Gompel JJ; Division of Neurosurgery, Mayo Clinic, Rochester, Minn., Stokken J; Division of Otolaryngology, Mayo Clinic, Rochester, Minn., Mardini S; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, Minn., Gibreel W; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, Minn.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2023 Nov 09; Vol. 11 (11), pp. e5392. Date of Electronic Publication: 2023 Nov 09 (Print Publication: 2023).
DOI:	10.1097/GOX.0000000000005392
Abstrakt:	After a transnasal endoscopic resection of a high-grade adenoid cystic carcinoma that underwent adjuvant chemoradiation, there was delayed recurrence managed by en bloc resection through an open craniofacial approach. Subsequently, the patient developed a chronic nasocranial fistula with secondary infection and bone flap resorption. This resulted in infectious episodes with secondary scalp incisional dehiscence and hardware exposure which required multiple bone debridement procedures, hardware removal, prolonged IV antibiotics, and hyperbaric oxygen treatment. The nasocranial fistula and chronic frontal bone osteomyelitis persisted despite the previous interventions. The patient underwent a frontal bone removal and obliteration of the anterior cranial base fistula with a free vastus lateralis muscle flap. At 4 weeks postoperatively, the intranasal portion of the muscle flap had completely mucosalized. After a 6-week course of IV antibiotics, a secondary cranioplasty using a custom-made poly-ether-ether-ketone implant was performed. The patient remained disease- and infection-free for the duration of follow-up (17 months). Competing Interests: The authors have no financial interest to declare in relation to the content of this article. (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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