Temporo-parietal muscle pedicle flap for reconstruction of the anterior skull base after resection of recurrent olfactory groove meningioma: a technical note.

ABSTRACT

Reconstruction becomes the main issue in surgery for tumours penetrating the anterior skull base because it faces the nasal cavity. Vascularized flaps are desirable for preventing infection, but in re-opening surgery, tissue availability is limited. We report a case of recurrent olfactory groove meningioma in which the anterior skull base defect was reconstructed using a temporo-parietal muscle (TPM) pedicle flap. A 65-year-old woman presented with recurrent olfactory groove meningioma penetrating the anterior skull base. Because the frontal pericranium had been used in the initial surgery, the temporal fascia was harvested with a TPM pedicle flap from behind the initial bicoronal incision. After removal of the tumour, the pedicle flap reached the sphenoid planum easily and was sutured to the surrounding structures. The fascia lata was sutured as an inlay. The postoperative course was uneventful, and no cerebrospinal fluid leakage was observed. In re-opening surgery, a TPM pedicle flap can be an option for reconstruction of the anterior skull base.