The Reverse-Flow Facial Artery Buccinator Flap for Skull Base Reconstruction: Key Anatomical and Technical Considerations
Identifieur interne : 000C52 ( Main/Curation ); précédent : 000C51; suivant : 000C53The Reverse-Flow Facial Artery Buccinator Flap for Skull Base Reconstruction: Key Anatomical and Technical Considerations
Auteurs : Zainab Farzal ; Ana M. Lemos-Rodriguez ; Rounak B. Rawal ; Lewis J. Overton ; Satyan B. Sreenath ; Mihir R. Patel ; Adam M. ZanationSource :
- Journal of Neurological Surgery. Part B, Skull Base [ 2193-6331 ] ; 2015.
Abstract
Url:
DOI: 10.1055/s-0035-1551669
PubMed: 26682122
PubMed Central: 4671905
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<author><name sortKey="Farzal, Zainab" sort="Farzal, Zainab" uniqKey="Farzal Z" first="Zainab" last="Farzal">Zainab Farzal</name>
<affiliation><nlm:aff id="AF140135-1"><institution>Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, United States</institution>
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<author><name sortKey="Lemos Rodriguez, Ana M" sort="Lemos Rodriguez, Ana M" uniqKey="Lemos Rodriguez A" first="Ana M." last="Lemos-Rodriguez">Ana M. Lemos-Rodriguez</name>
<affiliation><nlm:aff id="AF140135-1"><institution>Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, United States</institution>
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<author><name sortKey="Rawal, Rounak B" sort="Rawal, Rounak B" uniqKey="Rawal R" first="Rounak B." last="Rawal">Rounak B. Rawal</name>
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<author><name sortKey="Overton, Lewis J" sort="Overton, Lewis J" uniqKey="Overton L" first="Lewis J." last="Overton">Lewis J. Overton</name>
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<author><name sortKey="Sreenath, Satyan B" sort="Sreenath, Satyan B" uniqKey="Sreenath S" first="Satyan B." last="Sreenath">Satyan B. Sreenath</name>
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<author><name sortKey="Patel, Mihir R" sort="Patel, Mihir R" uniqKey="Patel M" first="Mihir R." last="Patel">Mihir R. Patel</name>
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<author><name sortKey="Zanation, Adam M" sort="Zanation, Adam M" uniqKey="Zanation A" first="Adam M." last="Zanation">Adam M. Zanation</name>
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<affiliation><nlm:aff id="AF140135-3"><institution>Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States</institution>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Reverse-Flow Facial Artery Buccinator Flap for Skull Base Reconstruction: Key Anatomical and Technical Considerations</title>
<author><name sortKey="Farzal, Zainab" sort="Farzal, Zainab" uniqKey="Farzal Z" first="Zainab" last="Farzal">Zainab Farzal</name>
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<author><name sortKey="Lemos Rodriguez, Ana M" sort="Lemos Rodriguez, Ana M" uniqKey="Lemos Rodriguez A" first="Ana M." last="Lemos-Rodriguez">Ana M. Lemos-Rodriguez</name>
<affiliation><nlm:aff id="AF140135-1"><institution>Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, United States</institution>
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<author><name sortKey="Rawal, Rounak B" sort="Rawal, Rounak B" uniqKey="Rawal R" first="Rounak B." last="Rawal">Rounak B. Rawal</name>
<affiliation><nlm:aff id="AF140135-1"><institution>Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, United States</institution>
</nlm:aff>
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<author><name sortKey="Overton, Lewis J" sort="Overton, Lewis J" uniqKey="Overton L" first="Lewis J." last="Overton">Lewis J. Overton</name>
<affiliation><nlm:aff id="AF140135-1"><institution>Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, United States</institution>
</nlm:aff>
</affiliation>
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<author><name sortKey="Sreenath, Satyan B" sort="Sreenath, Satyan B" uniqKey="Sreenath S" first="Satyan B." last="Sreenath">Satyan B. Sreenath</name>
<affiliation><nlm:aff id="AF140135-1"><institution>Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, United States</institution>
</nlm:aff>
</affiliation>
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<author><name sortKey="Patel, Mihir R" sort="Patel, Mihir R" uniqKey="Patel M" first="Mihir R." last="Patel">Mihir R. Patel</name>
<affiliation><nlm:aff id="AF140135-2"><institution>Department of Otolaryngology, Emory University, Winship Cancer Institute, Atlanta, Georgia, United States</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zanation, Adam M" sort="Zanation, Adam M" uniqKey="Zanation A" first="Adam M." last="Zanation">Adam M. Zanation</name>
<affiliation><nlm:aff id="AF140135-1"><institution>Department of Otolaryngology—Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, United States</institution>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="AF140135-3"><institution>Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States</institution>
</nlm:aff>
</affiliation>
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<series><title level="j">Journal of Neurological Surgery. Part B, Skull Base</title>
<idno type="ISSN">2193-6331</idno>
<idno type="eISSN">2193-634X</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><p><bold>Objective</bold>
To highlight key anatomical and technical considerations for facial artery identification, and harvest and transposition of the facial artery buccinator (FAB) flap to facilitate its future use in anterior skull base reconstruction. Only a few studies have evaluated the reverse-flow FAB flap for skull base defects.</p>
<p><bold>Design</bold>
Eight FAB flaps were raised in four cadaveric heads and divided into thirds; the facial artery's course at the superior and inferior borders of the flap was measured noting in which incisional third of the flap it laid. The flap's reach to the anterior cranial fossa, sella turcica, clival recess, and contralateral cribriform plate were studied. A clinical case and operative video are also presented.</p>
<p><bold>Results</bold>
The facial artery had a near vertical course and stayed with the middle (⅝) or posterior third (⅜) of the flap in the inferior and superior incisions. Seven of eight flaps covered the sellar/planar regions. Only four of eight flaps covered the contralateral cribriform region. Lastly, none reached the middle third of the clivus.</p>
<p><bold>Conclusions</bold>
The FAB flap requires an understanding of the facial artery's course, generally seen in the middle third of the flap, and is an appropriate alternative for sellar/planar and ipsilateral cribriform defects.</p>
</div>
</front>
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