Skip to main content
NCBI home page
Skull Base Surgery logoLink to Skull Base Surgery
. 1995 Apr;5(2):117–121. doi: 10.1055/s-2008-1058942

Reconstruction of Scalp and Cranium Defect Utilizing Latissimus Dorsi Musculocutaneous and Serratus Anterior Muscle Free Flaps with Interpositional Anastomosis of T-Shaped Flap Artery

Case Report

Hajime Arai, Akira Yanai, Masanobu Nishida, Rie Yoshikata, Hajime Nakanishi, Kiyoshi Sato
PMCID: PMC1661821  PMID: 17171185

Abstract

The use of a combination musculocutaneous free flap, consisting of a latissimus dorsi flap and a serratus anterior flap, for reconstruction of a large scalp and cranium defect is described. The recipient artery, the superficial temporal artery (STA), was anastomosed to the flap artery, without sacrificing blood flow, by means of a special technique: forming the end of the flap artery into a T shape and interposing it between the two stumps of the transected STA, because the STA was crucial for tissue adjacent to the defect. The flap vein was anastomosed to the external jugular vein with a vein graft. The extensive defect was immediately closed with sutures, and there were no remarkable complications.

Full text

PDF
117

Images in this article

118Figure 1
on p.118
118Figure 2
on p.118
119Figure 3
on p.119
120Figure 4
on p.120

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barrow D. L., Nahai F., Fleischer A. S. Use of free latissimus dorsi musculocutaneous flaps in various neurosurgical disorders. J Neurosurg. 1983 Feb;58(2):252–258. doi: 10.3171/jns.1983.58.2.0252. [DOI] [PubMed] [Google Scholar]
  2. Bridger G. P., Baldwin M. Anterior craniofacial resection for ethmoid and nasal cancer with free flap reconstruction. Arch Otolaryngol Head Neck Surg. 1989 Mar;115(3):308–312. doi: 10.1001/archotol.1989.01860270050013. [DOI] [PubMed] [Google Scholar]
  3. Fisher J., Jackson I. T. Microvascular surgery as an adjunct to craniomaxillofacial reconstruction. Br J Plast Surg. 1989 Mar;42(2):146–154. doi: 10.1016/0007-1226(89)90196-3. [DOI] [PubMed] [Google Scholar]
  4. Harii K., Yamada A., Ishihara K., Miki Y., Itoh M. A free transfer of both latissimus dorsi and serratus anterior flaps with thoracodorsal vessel anastomoses. Plast Reconstr Surg. 1982 Nov;70(5):620–629. doi: 10.1097/00006534-198211000-00019. [DOI] [PubMed] [Google Scholar]
  5. Izquierdo R., Leonetti J. P., Origitano T. C., al-Mefty O., Anderson D. E., Reichman O. H. Refinements using free-tissue transfer for complex cranial base reconstruction. Plast Reconstr Surg. 1993 Sep;92(4):567–575. [PubMed] [Google Scholar]
  6. Jones N. F., Sekhar L. N., Schramm V. L. Free rectus abdominis muscle flap reconstruction of the middle and posterior cranial base. Plast Reconstr Surg. 1986 Oct;78(4):471–479. doi: 10.1097/00006534-198610000-00005. [DOI] [PubMed] [Google Scholar]
  7. Mollman H. D., Haines S. J. Risk factors for postoperative neurosurgical wound infection. A case-control study. J Neurosurg. 1986 Jun;64(6):902–906. doi: 10.3171/jns.1986.64.6.0902. [DOI] [PubMed] [Google Scholar]
  8. Olding M., Winski F. V., Aulisi E. Emergency free flap reconstruction of a facial gunshot wound. Ann Plast Surg. 1993 Jul;31(1):82–86. [PubMed] [Google Scholar]
  9. Olsen K. D., Meland N. B., Ebersold M. J., Bartley G. B., Garrity J. A. Extensive defects of the sino-orbital region. Results with microvascular reconstruction. Arch Otolaryngol Head Neck Surg. 1992 Aug;118(8):828–860. doi: 10.1001/archotol.1992.01880080050012. [DOI] [PubMed] [Google Scholar]
  10. Robson M. C., Zachary L. S., Schmidt D. R., Faibisoff B., Hekmatpanah J. Reconstruction of large cranial defects in the presence of heavy radiation damage and infection utilizing tissue transferred by microvascular anastomoses. Plast Reconstr Surg. 1989 Mar;83(3):438–442. doi: 10.1097/00006534-198903000-00004. [DOI] [PubMed] [Google Scholar]
  11. Tokoro K., Chiba Y., Tsubone K. Late infection after cranioplasty--review of 14 cases. Neurol Med Chir (Tokyo) 1989 Mar;29(3):196–201. doi: 10.2176/nmc.29.196. [DOI] [PubMed] [Google Scholar]
  12. Ueda K., Harashina T., Inoue T., Tanaka I., Harada T. Microsurgical scalp and skull reconstruction using a serratus anterior myo-osseous flap. Ann Plast Surg. 1993 Jul;31(1):10–14. [PubMed] [Google Scholar]
  13. Whitney T. M., Buncke H. J., Alpert B. S., Buncke G. M., Lineaweaver W. C. The serratus anterior free-muscle flap: experience with 100 consecutive cases. Plast Reconstr Surg. 1990 Sep;86(3):481–491. [PubMed] [Google Scholar]
  14. Yamada A., Harii K., Ueda K., Asato H. Free rectus abdominis muscle reconstruction of the anterior skull base. Br J Plast Surg. 1992 May-Jun;45(4):302–306. doi: 10.1016/0007-1226(92)90057-5. [DOI] [PubMed] [Google Scholar]

Articles from Skull base surgery are provided here courtesy of Thieme Medical Publishers

RESOURCES