Gluteus Maximus Muscle Flap in Tongue in Groove and Wrap Around Pattern for Refractory CSF Leakage in Extradural Cyst Patient

Archives of Plastic Surgery

Jae Jun Shim¹  Hyun Ju Lee²  Kyong Chan Park³  Hwan Jun Choi⁴  Jun Ho Lee⁴ 

[1] Department of Neurosurgery, College of Medicine, Soonchunhyang University, Cheonan, Korea;Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan, Korea;Department of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University, Bucheon, Korea;Department of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University, Cheonan, Korea;

关键词: tongue in groove and wrap around pattern;    gluteus maximus muscle flap;    extradural cyst;    cerebrospinal fluid;    sacral defect;   

DOI  :  10.1055/s-0042-1748650

来源: DOAJ

【 摘 要 】

Spinal extradural arachnoid cyst (SEAC) is a rare disease and has surgical challenges because of the critical surrounding anatomy. We describe the rare case of a 58-year-old woman who underwent extradural cyst total excision with dural repair and presented with refractory cerebrospinal fluid (CSF) leakage even though two consecutive surgeries including dural defect re-repair and lumbar-peritoneal shunt were performed. The authors covered the sacral defect using bilateral gluteus maximus muscle flap in tongue in groove and wrap around pattern for protection of visible sacral nerve roots and blockage of CSF leakage point. With the flap coverage, the disappearance of cyst and fluid collection was confirmed in the postoperative radiological finding, and the clinical symptoms were significantly improved. By protecting the sacral nerve roots and covering the base of sacral defect, we can minimize the risk of complication and resolve the refractory fluid collection. Our results suggest that the gluteus muscle flap can be a safe and effective option for sacral defect and CSF leakage in extradural cyst or other conditions.

【 授权许可】

Unknown