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Free Latissimus Dorsi Myocutaneous Flap in a 6-Month-Old Child for Reconstruction of a Temporal Fossa Defect After Teratoma Resection

Fried, Frederik W., MD*; Beier, Justus P., MD*†; Bohr, Christopher, MD; Iro, Heinrich, MD§; Horch, Raymund E., MD*; Arkudas, Andreas, MD*

doi: 10.1097/SAP.0000000000001629

Although free flap reconstruction has already gained widespread acceptance in pediatric patients, little is known about the outcome of free tissue transfer in head and neck reconstruction in pediatric patients. We present a case of a 6-month-old boy with a large volume deficit in the right temporal fossa after resection of a teratoma. This led to a large volume deficit with widely undermined skin margins. Therefore, we provided volume augmentation by microsurgical free latissimus dorsi myocutaneous flap transplantation. Intraoperative use of laser-assisted indocyanine green angiography indicated excellent flap perfusion. Postoperative magnetic resonance imaging showed adequate flap perfusion with no signs of flap necrosis. To our best knowledge, this case presents the youngest patient who underwent free flap transplantation in the head and neck region. Our case demonstrates that microvascular surgery can play an important role in particular cases in pediatric oncology, even in very young patients.

From the *Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen;

Department of Plastic Surgery, Hand Surgery, Burn Surgery, University Hospital RWTH Aachen, Aachen

Department of Otorhinolaryngology–Head and Neck Surgery, University of Regensburg, Regensburg; and

§Department of Otorhinolaryngology–Head and Neck Surgery, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany.

Received April 16, 2018, and accepted for publication, after revision August 2, 2018.

Conflicts of interest and sources of funding: none declared.

Reprints: Frederik W. Fried, MD, Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg, Krankenhausstrasse 12, Erlangen 91054, Germany. E-mail:

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