%0 Journal Article
%T A Systematic Review on Outcomes of Anterior Skull Base Reconstruction.
%A Lim X
%A Rajagopal R
%A Silva P
%A Jeyaretna DS
%A Mykula R
%A Potter M
%J J Plast Reconstr Aesthet Surg
%V 73
%N 11
%D Nov 2020
%M 32546425
%F 3.022
%R 10.1016/j.bjps.2020.05.044
%X <B>BACKGROUND: </B>Anterior skull base resection often results in large defects that need to be reconstructed. This can be done using loco-regional, free flaps or both.<BR><B>OBJECTIVE: </B>The aim of this systematic review is to evaluate the surgical outcomes (mortality, complication rates and functional outcomes) for patients undergoing anterior skull base reconstruction.<BR><B>METHODS: </B>Electronic databases (MEDLINE, EMBASE and Scopus) were systematically searched for relevant articles from 1974 to March 2018. A total of 41 studies were included in this systematic review. No randomized controlled trials were identified; therefore, a meta-analysis was not performed.<BR><B>RESULTS: </B>Mortality from anterior skull base reconstruction were about 0-4% for loco-regional flaps while free flaps were around 0-7%. Overall complications ranged from 0% to 43% in loco-regional flaps, while rate of complications for free flaps ranged from 25% to 66.7%. Flap complications ranged from 0% to 14% for free flaps and 0% to 35% for local flaps. Quality-of-life measures did not differ significantly depending on surgical approach but were worse for patients with malignancies.<BR><B>CONCLUSIONS: </B>Due to varying standards of reporting of outcomes, lack of a standardized classification system for anterior skull base defects and absence of clinical trials, we were unable to perform a meta-analysis in this systematic review. Recommendations to guide future studies are proposed.