Article
Pericranial flap for the reconstruction of the internal nasal lining
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Authors
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Serkan Sertel
- Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Suisse
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Stephen S. Park
- University of Virginia, Charlottesville, USA
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Philippe Pasche
- Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Suisse
| Published: | March 26, 2015 |
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Outline
Text
Introduction: The galea and pericranial flaps are widely used in anterior skull base reconstructive surgery. We evaluated the potential use of the pericranial flap for the internal nasal lining in an anatomical study and present our experiences in two representative patients (I) patient with a melanoma of the septum and the lateral wall of the nose (II) patient with a meningioma of the anterior skull base with extension to the nasal bone and septum.
Methods: The anatomical study was performed on four fresh cadavers, in which we stained the internal and external carotid arteries in order to determine the pattern of vascularisation, axial distribution and length of the supraorbital (SOA) and supratrochlear (STA) arteries, as well as the length and width of the pericranial flap. This knowledge was then applied in reconstructive nasal surgery.
Results: The length of the deep STA and SOA were 35±10.4 mm and 70.7±13.9 mm, respectively. The division of deep and superficial vessels above the rim were STA 6.8±3.3 mm and 7.8±3.7 mm, respectively. Vascularisation was poor across the midline. The base of the flap was 108.5±8.5mm. A flap for total nasal reconstruction with a length of approximately 95mm, needed a length of 72.5±5 mm for the tip and +22 mm for the columella.
Conclusion: The pericranial flap is mainly based on the supraorbital arteries. Superficial dissection must end 15mm above the orbital rim. The pericranial flap shows good results in skull base, combined nasocranial, septal and nasal defects.
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