The Vascular Anatomy of the Galeal Flap in the Interparietal and Midline Regions

Har-Shai, Y.; Fukuta, Keizo; Collares, Marcus Vinícius Martins; Stefanović, P; Filipović, Branislav; Herschman, Barry R.; Jackson, Ian T.

doi:10.1097/00006534-199201000-00012

Cited by 21 publications

(8 citation statements)

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“…These secondary branches generate a rich vascular network over the galea, which delimits temporoparietal galeal flaps with an average area of 150.63 cm 2 . Our findings corroborate those of some researchers that point to the feasibility of obtaining large galeal flaps based on superficial temporal vessels 20,23. The maximum distance of the flap pedicle, measured from the artery trunk in front of the auditory canal to artery’s terminal branches over the galea, had an average value of 15.81 cm.…”

Section: Discussionsupporting

confidence: 90%

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Galeal Flap Based on Superficial Temporal Vessels for Oral Cavity and Pharynx Reconstruction – An Anatomical Study

Pinto

Magalhães

Durazzo

et al. 2008

Clinics

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Pinto F, Magalhães R, Durazzo M, Brandão L, Rodrigues Jr. AJ. Galeal flap based on superficial temporal vessels for oral cavity and pharynx reconstruction -an anatomical study. Clinics. 2008;63(1);97-102. PURPOSE:Despite the advances in microvascular free tissue transfer for intraoral reconstruction, this surgery is not recommended for all patients. In specific cases, the pedicled temporoparietal galeal flap may be an option for reconstructive procedures in the head and neck regions. The objective of this paper is to present the anatomical aspects of a galeal flap based on the superficial temporal vessels and to test its potential for reconstructing diverse sites of the oral cavity and pharynx. METHODS: We performed 40 dissections on 34 fresh adult cadavers. The flap vascular anatomy was studied by injecting latex into the superficial temporal vessels. A standardized square-shape flap measuring 10 x 10 cm 2 , pedicled on the superficial temporal vessels, was raised. Oral cavity and oropharynx reconstruction simulations were performed after flap transposition into the mouth by passing it under the zygomatic arch. Hypopharyngeal reconstruction was tested by transposing the flap to the neck under the facial nerve. RESULTS: After latex injection, a rich vascular network over the temporoparietal galea was observed directly from the superficial temporal artery, and a well-vascularized flap based on this vessel was raised. In the reconstruction simulations, the flap was shown to be suitable for the coverage of hypothetical defects in most oral cavity and pharyngeal sites, mainly the retromolar trigone, tonsil area, and buccal mucosa. CONCLUSIONS: A galeal flap based on the superficial temporal vessels presents favorable anatomical characteristics for oral cavity and pharyngeal reconstruction.

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Section: Discussionsupporting

confidence: 90%

“…The maximum distance of the flap pedicle, measured from the artery trunk in front of the auditory canal to artery’s terminal branches over the galea, had an average value of 15.81 cm. This measurement is similar to findings by Har-Shai et al23 and confers a satisfactory rotation arc to the flap.…”

Section: Discussionsupporting

confidence: 90%

Galeal Flap Based on Superficial Temporal Vessels for Oral Cavity and Pharynx Reconstruction – An Anatomical Study

Pinto

Magalhães

Durazzo

et al. 2008

Clinics

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“…As well as the TMP flap, we have used a frontal pericranial flap (FP flap) that does not contain the galea and the frontal muscle in the forehead (1, 21, 28), a frontal galeapericranial flap (FGP flap) that includes the galea and the frontal muscle (8,10,12,20,22,29), a galeal flap with the superficial temporal artery as its pedicle (10,12,16,25), a pedicled myocutaneous flap (23,24), and free flaps (2-4, 11, 14, 31) to reconstruct the anterior base of the skull. The circulation in the FP flap is slightly unstable as we found partial necrosis in two of the three that we did.…”

Section: Comparison Between the Tmp Flap And Other Flapsmentioning

confidence: 99%

Efficacy of Temporal Musculopericranial Flap for Reconstruction of the Anterior Base of the Skull

Kiyokawa

Tai²,

Inoue³

et al. 2000

Scandinavian Journal of Plastic and Reconstructive Surgery and

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Since March 1988 the temporal musculopericranial (TMP) flap has been used as our flap of choice to reconstruct defects of the anterior base of the skull that are larger than 2 x 3 cm, including the dura mater, in 33 patients. The primary diseases were malignant head and neck tumours (n = 16), trauma (n = 15), meningioma (n = 1), and teratoma (n = 1). The dura mater was reconstructed with a unilateral TMP flap, after which the cranial and nasal cavities were closed with the opposite TMP flap. In addition, bone was grafted by sandwiching the bone between the two flaps and fixing it to the surrounding residual bone. When a large area was resected, making it impossible to use a TMP flap, a frontal musculopericranial (FMP) flap or a free flap (usually the rectus abdominis myocutaneous flap) was used to close the cranial and nasal cavities. Thirty of the 33 patients recovered with no postoperative complications. Two patients developed extradural abscesses in the anterior base of the skull and one developed mild meningitis, but they were successfully treated conservatively. When bilateral TMP flaps were used for the reconstruction, no patient had aesthetic problems in the forehead region. The TMP flap is extremely effective for the reconstruction of the anterior base of the skull because it is minimally invasive and causes few aesthetic problems in the forehead region.

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“…In studies on structures and vascularization of the scalp and temporal areas, a variety of local flaps have been suggested for reconstruction [6][7][8]. In these studies, the temporoparietal fascia was found to contain the superficial temporal artery (STA), and its collateral vessels ensured the vascularization of the scalp.…”

Section: Introductionmentioning

confidence: 99%

Superficial Temporal Artery Based Pedicled Flap for the Reconstruction of Traumatic Complicated Scalp Defects

et al. 2020

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Reconstruction of traumatic defects on the scalp can be challenging. In cases of skull trauma, direct incisions close to bony defects can lead to skin and soft tissue necrosis. To minimize hair damage after surgery and to achieve both reconstructive and cosmetic effects, we propose a superficial temporal artery based pedicled flap for complicated traumatic cranial defects and lacerations. In the present case, a 21-year-old woman suffered intracranial hemorrhage with multiple skin and soft tissue injuries on her scalp after a violent attack. Neurosurgeons made a bicoronal incision for intracranial surgery and cranioplasty with a meshed plate, however 3×2.5 cm skin and soft tissue necrosis occurred on the mid-scalp near the vertex with plate exposure. We therefore elevated a 15×8 cm-sized pedicled flap based on a unilateral superficial temporal artery and transferred it to the defect without tension. The donor site was closed in a V-Y advancement pattern. Healing was uneventful, with good hairline and hair growth patterns observed. From our experience, we suggest a superficial temporal artery pedicled flap for complicated traumatic scalp defects.

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The Vascular Anatomy of the Galeal Flap in the Interparietal and Midline Regions

Cited by 21 publications

References 0 publications

Galeal Flap Based on Superficial Temporal Vessels for Oral Cavity and Pharynx Reconstruction – An Anatomical Study

Galeal Flap Based on Superficial Temporal Vessels for Oral Cavity and Pharynx Reconstruction – An Anatomical Study

Efficacy of Temporal Musculopericranial Flap for Reconstruction of the Anterior Base of the Skull

Superficial Temporal Artery Based Pedicled Flap for the Reconstruction of Traumatic Complicated Scalp Defects

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