Soft tissue considerations in lateral craniofacial reconstruction

The lateral skull base is a complex anatomic structure composed of composite tissues. It plays a highly significant role in the cosmetic and sensory functions of the head and neck. Many disease processes can involve this area. Fortunately, surgical treatment of this lateral skull base can be done in a manner that minimally affects cosmesis as well as the neural, vestibular, and otologic function of the auditory system. Occasionally, disease processes may necessitate significant removal of soft tissue components of the lateral skull base. Skin and subcutaneous tissue, the auricle, the mastoid cavity, or lateral temporal bone may need to be resected. In these cases, consideration for soft tissue reconstruction of the composite defect needs to be undertaken to maintain cosmetic as well as functional rehabilitation. This chapter will discuss the various options available based on the degree of soft tissue loss.