Wide reconstruction of the anterior cranial base with bipedicled galeopericranial flap.

Abstract

Reconstruction of facial bone fractures complicated by frontal sinus destruction must seal off the cranial cavity from the upper respiratory tract to avoid ascending infections of the intracranial contents. We used a bipedicled galeopericranial flap for reconstruction of the extradural and subcutaneous spaces of the frontal region, which were infected with methicillin-resistant Staphylococcus aureus (MRSA) following unsuccessful coverage of the anterior cranial base with an anteriorly based pericranial flap. The patient healed uneventfully without infection. Because a bipedicled galeopericranial flap has abundant blood supply, it can be used to cover a wide segment of the anterior cranial base. This is the first report of the application of a bipedicled galeopericranial flap for wide reconstruction of the anterior cranial base.