Vascularized outer-table calvarial bone flaps.
Based on an anatomic study of the vascularization of the calvarium in cadavers, a technique for the transfer of vascularized outer-table calvarial bone has been developed. The outer table of the calvarium receives numerous small perforators from its overlying periosteum. The periosteum is continuous with a distinct fascial layer overlying the temporal aponeurosis which we have termed the innominate fascia. Because of a network of anastomosing vessels from proximal branches of the superficial temporal artery and perforating branches of the deep temporal artery, the outer table of the calvarium can be carried on a pedicle which contains the temporal aponeurosis, innominate fascia, and periosteum. Thirty-seven vascularized outer-table calvarial bone flaps have been performed for a variety of craniofacial reconstructive deformities. Remarkable stability and lack of resorption have led the authors to favor this method of reconstruction particularly in poorly vascularized or previously infected recipient beds.
D000293:Adolescent; D000328:Adult; D002648:Child; D005145:Face / Q000002:abnormalities / Q000601:surgery*; D005151:Facial Injuries / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D012886:Skull / Q000098:blood supply / Q000637:transplantation*; D013518:Surgery, Plastic / Q000379:methods; D013524:Surgical Flaps