Occipitoparietal Bone Flap for Mandibular Reconstruction

Dogliotti, Pedro; Bennun, Ricardo D.

doi:10.1097/00001665-199505000-00013

Cited by 12 publications

(19 citation statements)

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“…Use of this large artery is advantageous, providing a long pedicle and thus enhancing the versatility of the flap [17]. Dissection of the pedicle is facilitated by detachment of the overlying neck musculature, including the sternocleidomastoid (SCM) [18]. Furthermore, the anatomy of the blood supply to the OGP shows a high rate of consistency between individuals, facilitating a reliably successful dissection [18].…”

Section: Pedicled Extranasal Flap Optionsmentioning

confidence: 99%

“…Dissection of the pedicle is facilitated by detachment of the overlying neck musculature, including the sternocleidomastoid (SCM) [18]. Furthermore, the anatomy of the blood supply to the OGP shows a high rate of consistency between individuals, facilitating a reliably successful dissection [18]. Transposition takes place through a tunnel along the inferomedial surface of the medial pterygoid muscle requires a wide endoscopic maxillary antrostomy and posterior maxillectomy as well as removal of the inferior aspect of the pterygoid plates[18].…”

Section: Pedicled Extranasal Flap Optionsmentioning

confidence: 99%

“…Furthermore, the anatomy of the blood supply to the OGP shows a high rate of consistency between individuals, facilitating a reliably successful dissection [18]. Transposition takes place through a tunnel along the inferomedial surface of the medial pterygoid muscle requires a wide endoscopic maxillary antrostomy and posterior maxillectomy as well as removal of the inferior aspect of the pterygoid plates[18]. Finally, the distance of the flap from the skull base itself makes the OGP an excellent choice in patients who have previously undergone surgery or radiotherapy [18].…”

Section: Pedicled Extranasal Flap Optionsmentioning

confidence: 99%

“…In addition, more ventral positioning of the OGP increases the risk of compression of bulkier, more distal portions of the flap, and may pose a threat of venous congestion and flap compromise [18]. Of note, harvesting the OGP does require transection or detachment of several neck muscles, including the SCM and trapezius.…”

Section: Pedicled Extranasal Flap Optionsmentioning

confidence: 99%

“…Of note, harvesting the OGP does require transection or detachment of several neck muscles, including the SCM and trapezius. However, Dogliotti and colleagues [18] described favorable outcomes with reattachment in their use of this flap for mandibular reconstruction, noting no residual neck muscle weakness. Dissection of the pedicle to its proximal extent might also pose the threat of carotid injury; however, ample pedicle length is available without such extensive dissection [18].…”

Section: Pedicled Extranasal Flap Optionsmentioning

confidence: 99%

See 4 more Smart Citations

Pedicled Extranasal Flaps in Skull Base Reconstruction

Kim

Hang

Mitchell

et al. 2012

Advances in Oto-Rhino-Laryngology

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Cerebrospinal fluid (CSF) leaks most commonly arise during or after skull base surgery, although they occasionally present spontaneously. Recent advances in the repair of CSF leaks have enabled endoscopic endonasal surgery to become the preferred option for management of skull base pathology. Small defects (<1cm) can be repaired by multilayered free grafts. For large defects (>3cm), pedicled vascular flaps are the repair method of choice, resulting in much lower rates of postoperative CSF leaks. The pedicled nasoseptal flap (NSF) constitutes the primary reconstructive option for the vast majority of skull base defects. It has a large area of potential coverage and high rates of success. However, preoperative planning is required to avoid sacrificing the NSF during resection. In cases where the NSF is unavailable, often due to tumor involvement of the septum or previous resection removing or compromising the flap, other flaps may be considered. These flaps include intranasal options—inferior turbinate (IT) or middle turbinate (MT) flaps—as well as regional pedicled flaps: pericranial flap (PCF), temporoparietal fascial flap (TPFF), or palatal flap (PF). More recently, novel alternatives such as the pedicled facial buccinator flap (FAB) and the pedicled occipital galeopericranial flap (OGP) have been added to the arsenal of options for skull base reconstruction. Characteristics of and appropriate uses for each flap are described.

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Section: Pedicled Extranasal Flap Optionsmentioning

confidence: 99%