Reconstruction of Lateral Skull Base Defects with Radial Forearm Free Flaps: The Double-Layer Technique

IntroductionThe radial forearm flap has fallen out of favor in lateral skull base reconstruction in recent literature. However, especially when used in a double layer, a radial forearm may be able to provide the thickness of a large flap while taking advantage of the pliability for which the flap is renowned. ObjectiveTo report the results of the double-layer technique of radial forearm free flap reconstruction of lateral temporal bone defects. DesignA retrospective chart review. SettingA tertiary care institution. ParticipantsAll consecutive patients who underwent lateral temporal bone resections and were reconstructed with free flaps from 2006 to 2012. Major Outcome MeasuresFlap success rate, complications, and rate of revision surgery. ResultsA total of 17 patients were identified with free flap reconstruction of the lateral skull base. Seven received reconstruction with a double-layer radial forearm flap. Reconstruction-related complications in this group included one case of facial cellulitis. The flap success rate was 100%. These results were comparable with patients who had other flaps. ConclusionsThe radial forearm free flap may be an effective reconstruction option for lateral temporal bone defects especially when used in the double-layer technique.