Novel Myocutaneous Hemicraniectomy Flap: Technical Note and Cadaveric Dissection Using the “Feng-Huang Technique”

Abstract

Background: The hemicraniectomy is a common technique used in a variety of pathologies including some traumatic brain injury and malignant stroke. A novel technique of performing hemicraniectomies using a retro-auricular incision can avoid transgressing the temporalis muscle and superficial temporal artery while providing adequate hemicranial exposure. Method: This technique was reproduced in a skull base lab using a cadaveric head. The key steps of this approach were illustrated in step-by-step fashion. A post-approach CT scan of the cadaver was performed to evaluate the decompression exposure. Results: This approach is able to provide sufficient middle fossa decompression and area of exposure, while preserving the temporalis along with the superficial temporal artery. Conclusions: The altered retro-auricular flap (the “Feng-Huang” flap) is a novel technique for hemicraniectomy which can provide sufficient middle fossa decompression and exposure while sparing the temporalis muscle and superficial temporal artery during the approach. A step-by-step technical illustration is demonstrated in the present note.