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Skull Base 2003; 13(4): 205-208
DOI: 10.1055/s-2004-817696
ORIGINAL ARTICLE

Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

The Use of Unilateral Pericranial Flaps for the Closure of Difficult Medial Orbital and Upper Lateral Nasal Defects

Jason Newman1 , Peter Costantino2 , Jason Moche3
  • 1New York Presbyterian Medical Center, New York, New York
  • 2St. Luke's-Roosevelt Medical Center, New York, New York
  • 3Mount Sinai Medical Center, New York, New York
Further Information

Publication History

Publication Date:
18 May 2004 (online)

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ABSTRACT

We present 3 cases in which a unilateral pericranial flap was used to repair defects in the medial orbital and upper lateral nasal areas. All three patients had undergone previous excision of malignant tumors from the upper septum and ethmoid areas. Postoperatively, they all received radiation and then developed wound breakdown with fistula formation, particularly in the area of the incisional site. All 3 patients had undergone previous unsuccessful repair of the fistula. Closure of such fistulas requires well-vascularized nonradiated tissue, which can be provided by a unilateral pericranial flap. This flap is flexible, thin, and well suited to the sinonasal area. Use of this flap avoids the need for a paramedian forehead or other musculocutaneous flap. Cosmetic results were excellent, and there have been no flap breakdowns or complications to date.

KEYWORDS

Pericranial flap - nasocutaneous fistula - sino-nasal cancer

REFERENCES

  • 1 Lewis J S, Castro E B. Cancer of the nasal cavity and paranasal sinuses.  J Laryngol Otol . 1972;  86 255-262
    PubMedSearch in Google Scholar
  • 2 Flores A D, Anderson D W, Doyle P J. Paranasal sinus malignancy: A retrospective analysis of treatment methods.  J Otolaryngol . 1984;  13 141-146
    PubMedSearch in Google Scholar
  • 3 Van Buren M J, Ommaya A K, Ketcham A S. Ten years experience with radical combined craniofacial resection of malignant tumors of the paranasal sinuses.  J Neurosurg . 1968;  28 341-350
    CrossrefPubMedSearch in Google Scholar
  • 4 Potparic Z, Fukuta K, Colen L B. Galeo-pericranial flaps in the forehead: a study of blood supply and volumes.  Br J Plast Surg . 1996;  49(8) 519-528
    CrossrefPubMedSearch in Google Scholar
  • 5 Johns M, Winn H R, McLean W C. Pericranial flap for the closure of defects of craniofacial resections.  Laryngoscope . 1981;  91 952-958
    PubMedSearch in Google Scholar
  • 6 Shah J P, Galicich J H. Craniofacial resection for malignant tumors of ethmoid and anterior skull base.  Arch Otolaryngol . 1977;  103 514-517
    CrossrefPubMedSearch in Google Scholar
  • 7 Fukuta K, Avery C, Jackson Y T. Long term complications of the galeal-frontalis myofascial flap in craniofacial surgery.  Eur J Plast Surg . 1993;  16 174-176
    PubMedSearch in Google Scholar
  • 8 Argenta L C, Friedman R J, Dingman R O. The versatility of pericranial flaps.  Plast Reconstr Surg . 1985;  76(5) 695-702
    PubMedSearch in Google Scholar