Strategies and flap design for reconstruction of extensive skull and skull base defects

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Ramin Ipaktchi, Peter M Vogt, Tobias Mett and Viola Stögner

Hannover Medical School, Germany

: J Otol Rhinol

Abstract

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Anatomic defects of the skull and skull base remain a surgical challenge. In most cases head and neck reconstructive surgery succeeds well by employing standard techniques of regional flaps or free microvascular grafts. Larger and unconventional resections however require advanced techniques to provide an adequate functional and aesthetic result. These may include pedicled or free flaps of various options to protect vulnerable anatomic structure including intracranial structures, skull base, blood vessels and the nasopharyngeal cavity. The presentation outlines complex reconstructions applicable to the skull and skull base and gives recommendations for surgical choices. Thereby it covers specific problems to be encountered and provides individualized solutions. The authors present solutions for microvascular free tissue transfer in the “avascular neck“ by construction of arteriovenous loops for later hook up of a flap and special flap designs for difficult to access regions in the scull base.

Biography

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Ramin Ipaktchi is a Chief of Burn Surgery and Senior Consultant for Medical School Hannover, Germany. He is a Board Certified General Surgery Doctor in Switzerland/Germany and Plastic, Aesthetic, Reconstructive Surgery in Switzerland/Germany and Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery.