Search tips
Search criteria 


Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
Skull base surgery. 1995 April; 5(2): 117–121.
PMCID: PMC1661821

Reconstruction of Scalp and Cranium Defect Utilizing Latissimus Dorsi Musculocutaneous and Serratus Anterior Muscle Free Flaps with Interpositional Anastomosis of T-Shaped Flap Artery

Case Report


The use of a combination musculocutaneous free flap, consisting of a latissimus dorsi flap and a serratus anterior flap, for reconstruction of a large scalp and cranium defect is described. The recipient artery, the superficial temporal artery (STA), was anastomosed to the flap artery, without sacrificing blood flow, by means of a special technique: forming the end of the flap artery into a T shape and interposing it between the two stumps of the transected STA, because the STA was crucial for tissue adjacent to the defect. The flap vein was anastomosed to the external jugular vein with a vein graft. The extensive defect was immediately closed with sutures, and there were no remarkable complications.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.5M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Olsen KD, Meland NB, Ebersold MJ, Bartley GB, Garrity JA. Extensive defects of the sino-orbital region. Results with microvascular reconstruction. Arch Otolaryngol Head Neck Surg. 1992 Aug;118(8):828–860. [PubMed]
  • Jones NF, Sekhar LN, Schramm VL. Free rectus abdominis muscle flap reconstruction of the middle and posterior cranial base. Plast Reconstr Surg. 1986 Oct;78(4):471–479. [PubMed]
  • Fisher J, Jackson IT. Microvascular surgery as an adjunct to craniomaxillofacial reconstruction. Br J Plast Surg. 1989 Mar;42(2):146–154. [PubMed]
  • Izquierdo R, Leonetti JP, Origitano TC, al-Mefty O, Anderson DE, Reichman OH. Refinements using free-tissue transfer for complex cranial base reconstruction. Plast Reconstr Surg. 1993 Sep;92(4):567–575. [PubMed]
  • Olding M, Winski FV, Aulisi E. Emergency free flap reconstruction of a facial gunshot wound. Ann Plast Surg. 1993 Jul;31(1):82–86. [PubMed]
  • Yamada A, Harii K, Ueda K, Asato H. Free rectus abdominis muscle reconstruction of the anterior skull base. Br J Plast Surg. 1992 May-Jun;45(4):302–306. [PubMed]
  • Bridger GP, Baldwin M. Anterior craniofacial resection for ethmoid and nasal cancer with free flap reconstruction. Arch Otolaryngol Head Neck Surg. 1989 Mar;115(3):308–312. [PubMed]
  • Barrow DL, Nahai F, Fleischer AS. Use of free latissimus dorsi musculocutaneous flaps in various neurosurgical disorders. J Neurosurg. 1983 Feb;58(2):252–258. [PubMed]
  • Robson MC, Zachary LS, Schmidt DR, Faibisoff B, Hekmatpanah J. Reconstruction of large cranial defects in the presence of heavy radiation damage and infection utilizing tissue transferred by microvascular anastomoses. Plast Reconstr Surg. 1989 Mar;83(3):438–442. [PubMed]
  • Ueda K, Harashina T, Inoue T, Tanaka I, Harada T. Microsurgical scalp and skull reconstruction using a serratus anterior myo-osseous flap. Ann Plast Surg. 1993 Jul;31(1):10–14. [PubMed]
  • Whitney TM, Buncke HJ, Alpert BS, Buncke GM, Lineaweaver WC. The serratus anterior free-muscle flap: experience with 100 consecutive cases. Plast Reconstr Surg. 1990 Sep;86(3):481–491. [PubMed]
  • Harii K, Yamada A, Ishihara K, Miki Y, Itoh M. A free transfer of both latissimus dorsi and serratus anterior flaps with thoracodorsal vessel anastomoses. Plast Reconstr Surg. 1982 Nov;70(5):620–629. [PubMed]
  • Mollman HD, Haines SJ. Risk factors for postoperative neurosurgical wound infection. A case-control study. J Neurosurg. 1986 Jun;64(6):902–906. [PubMed]
  • Tokoro K, Chiba Y, Tsubone K. Late infection after cranioplasty--review of 14 cases. Neurol Med Chir (Tokyo) 1989 Mar;29(3):196–201. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers