Tuesday, July 6, 2021

The Vascularized Occipital Fascial Flap ('OFF'): A Novel Reconstructive Technique for Posterior Fossa Surgery

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World Neurosurg. 2021 Jul 2:S1878-8750(21)00963-3. doi: 10.1016/j.wneu.2021.06.122. Online ahead of print.

ABSTRACT

BACKGROUND: Posterior fossa surgery is particularly prone to cerebrospinal fluid (CSF) leakage. Several methods have been introduced to address and/or prevent this complication. However, to the best of authors' knowledge, the use of a vascularized fascial flap based on the occipital artery for the purpose of reconstruction has not been reported. The authors introduce the occipital fascial flap (OFF) for reconstruction of a craniectomy defect after the retrosigmoid approach.

METHODS: A 57-year-old female with a large cerebellar metastasis underwent gross total resection of the mass followed by reconstruction of the craniectomy defect using OFF.

RESULTS: Post-operative imaging showed flap viability and no CSF leak occurred during follow-up.

CONCLUSIONS: We report the first use of OFF for reconstruction of a crani ectomy defect in a retrosigmoid approach. The vascularized fascial flap in posterior fossa surgery is a potentially helpful technique to reduce the risk of CSF leak in high-risk patients.

PMID:34224888 | DOI:10.1016/j.wneu.2021.06.122

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