Reconstruction of the anterior cranial base with a frontal muscle flap in cerebrospinal fluid fistulae.

Abstract

Craniofacial infection is a major problem for the plastic and neurosurgical team. Previous successful experiences with free muscle and omentum flaps and the galea frontalis myofascial flap have been reported, avoiding disastrous complications after frontofacial advancements and the resection of skull base tumors. The authors report the clinical use of the galea frontalis myofascial flap in the treatment of anterior fossa CSF leaks. This flap provides an adequate sized and vascularized barrier between the cranial and nasal cavities through which the cells of the inflammatory response reach the target area. This technique was used in 11 cases with complete success; in-6 patients, repair of the anterior cranial base bone defect was performed with split calvarium bone grafts, harvested from craniotomy bone. In all the patients, neither the recurrence of the CSF leakage nor post-operative meningitis or its recurrence were observed.