• Pankaj K Agarwalla, Ali Tayebi Meybodi, Max Ward, and Boris Paskhover.
• Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA. Electronic address: pka23@njms.rutgers.edu.
• World Neurosurg. 2021 Oct 1; 154: 32-38.

BackgroundPosterior fossa surgery is particularly prone to cerebrospinal fluid (CSF) leakage. Several methods have been introduced to address and/or prevent this complication. However, to the best of our knowledge, the use of a vascularized fascial flap based on the occipital artery for the purpose of reconstruction has not been reported. We introduce the occipital fascial flap (OFF) for reconstruction of a craniectomy defect after the retrosigmoid approach.MethodsA 57-year-old woman with a large cerebellar metastasis underwent gross total resection of the mass followed by reconstruction of the craniectomy defect using OFF.ResultsPostoperative imaging showed flap viability and no CSF leak occurred during follow-up.ConclusionsWe report the first use of OFF for reconstruction of a craniectomy defect in a retrosigmoid approach. The vascularized fascial flap in posterior fossa surgery is a potentially helpful technique to reduce the risk of CSF leak in high-risk patients.Copyright © 2021 Elsevier Inc. All rights reserved.

19 keywords...

hide…