Modification of periosteal flap as management of cerebrospinal fluid leakage after frontal sinus fracture surgery in moderate traumatic brain injury patients

 

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Main management for the frontal sinus fracture is using the pericranial flap. Pericranial flaps based on the supraorbital and supratrochlear vasculature have previously been used with significant success for the separation of intracranial and extracranial spaces after major trauma. Defect closure was modified due to lack of the frontal periosteum; the graft was made from the temporal side of periosteum to make primary periosteal flap longer. Defect closure could be optimum. Evaluation for 6 months showed a significant improvement without major complications. In this article, we propose a new modification technique as one of promising alternatives.

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Publication History

Received: 01 July 2019

Accepted: 19 November 2019

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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• References

• 1 Ravindra VM, Neil JA, Shah LM, Schmidt RH, Bisson EF. Surgical management of traumatic frontal sinus fractures: Case series from a single institution and literature review. Surg Neurol Int 2015;6:141.
• 2 Donath A, Sindwani R. Frontal sinus cranialization using the pericranial flap: An added layer of protection. Laryngoscope 2006;116:1585-8.
• 3 Fattahi T, Dipasquale J. Utility of the pericranial flap in frontal sinus and anterior cranial fossa trauma. Int J Oral Maxillofac Surg 2009;38:1263-7.
• 4 Ilankovan V, Adcock SD. The galeo pericranial flap in oropharyngeal reconstruction. Br J Oral Maxillofac Surg 1996;34:47-50.
• 5 Jensen R, McCutcheon IE, DeMonte F. Postoperative swelling of pericranial pedicle graft producing intracranial mass effect. report of two cases. J Neurosurg 1999;91:124-7.
• 6 Leatherbarrow B, Watson A, Wilcsek G. Use of the pericranial flap in medial canthal reconstruction: Another application for this versatile flap. Ophthalmic Plast Reconstr Surg 2006;22:414-9.
• 7 Paloma V, Samper A, Cervera-Paz FJ. Surgical technique for reconstruction of the nasal septum: the pericranial flap. Head Neck 2000;22:90-4.
• 8 Wang RC, Parisier SC, Weiss MH, Chute PM, Hellman SA, Sauris E. Cochlear implant flap complications. Ann Otol Rhinol Laryngol 1990;99:791-5.
• 9 Yoshioka N, Kishimoto S. Anteriorly based pericranial flap: an anatomic study of feeding arteries. Skull Base Surg 1991;1:161-4.
• 10 Yoshioka N, Rhoton AL Jr. Vascular anatomy of the anteriorly based pericranial flap. Neurosurgery 2005;57:11-6.