Reconstructive surgery of skull base region after malignant tumor excision

We have operated 38 patients for spread (T3-T4) tumors with reconstruction of craniomaxillofacial region. There were epidermoid and basal cell carcinomas, sarcomas and some other malignancies. In all the cases we used rotated or vascularized free tissue flaps: in 21 cases fascilocutaneous (from forearm, parascapular region or forehead), in 12 cases musculofascial (m. latissimus dorsi, m. serratus anterior and m. trapezium), in remaining 5 cases - vascularized omental flap. Complication rate was 30%, in 2 cases we observed insufficiency of vascular anastomoses. There was no postoperative mortality. 3-year mortality rate was 61.5%. The methods of craniofacial reconstruction with use of rotated and especially vascularized tissue flaps with costal fragments permit restoration of the facial skeleton and provide good cosmetic results.