Use of the splenius capitis muscle flap for reconstruction of the posterior neck and skull in complicated Arnold-Chiari malformation.

Abstract

A previously unreported muscle flap using the splenius capitis muscle is described. The flap proved to be of value in management of a difficult case of recurrent CSF leak complicating suboccipital craniectomy for the treatment of Arnold-Chiari malformation. The dura was repaired with a fasciae latae graft, and splenius capitis muscle flaps were used to obliterate the dead space and to complete the operative correction. This reversed a life-threatening situation while preserving the muscles' function and yielding a good cosmetic result. Flap anatomy and design are described for the success of this reconstruction.