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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(03): 365-368
DOI: 10.1055/s-0042-1748650
Breast/Trunk
Case Report

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

Kyong Chan Park
1   Department of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University, Bucheon, Korea
,
Jun Ho Lee
2   Department of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University, Cheonan, Korea
,
Jae Jun Shim
3   Department of Neurosurgery, College of Medicine, Soonchunhyang University, Cheonan, Korea
,
Hyun Ju Lee
4   Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan, Korea
,
Hwan Jun Choi
2   Department of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University, Cheonan, Korea
5   Institute of Tissue Regeneration, Soonchunhyang University, Cheonan, Korea
› Author Affiliations Funding This work was supported by grants from National Research Foundation of Korea (NRF), grants founded by the Korea government (MSIT) (No. 2020R1A2C110089), and was supported by Soonchunhyang University research fund.
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Abstract

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.

Keywords

tongue in groove and wrap around pattern - gluteus maximus muscle flap - extradural cyst - cerebrospinal fluid - sacral defect

Ethical Approval

The study was performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained.


Patient Consent

The patient provided written informed consent for the publication and the use of his images.


Author Contributions

Conceptualization : H.J.C. Data curation : J.J. S. and J.H.L. Methodology : H.J.L. Project administration : H.J.C. Writing-original draft : K.C.P. Writing-review and editing : K.C.P.




Publication History

Article published online:
27 May 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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