Reconstrução do nervo facial e da região temporal após ressecção de extenso tumor na base do crânio

Abstract

In this case report, a young patient with an extensive soft tissue tumor on the base of the skull is presented, affecting the internal carotid artery, facial nerve and bulging skin of the left retroauricular area. The tumor recurred after some previous approaches and the 15-year-old patient began to show signs of facial and vestibulocochlear nerve invasion. The surgical treatment was chosen, despite the concealed risks, in order to avoid the natural course of the tumor evolve to an inoperable stage. The extensive resection of the lesion lasted 26 hours of surgery with the multidisciplinary teams (neurosurgery, otorhinolaryngology, head and neck and plastic surgery). The facial nerve was reconstructed with autologous nerve graft and the large volumetric failure that exposed the brain was reconstructed with anterolateral myofasciocutaneous flap of the left thigh with vascular microanastomosis. The patient develops with stroke, meningitis and pneumonia. After two months of admission to the ICU, he improved favorably. There was recovery of the movement of the facial muscles, and the reconstruction of the temporal region was successful. Conclusion: Despite the complexity of the condition, the surgical treatment for the young patient is a plausible alternative.