[Anatomic study and preliminary clinical application of the laterally based pericranial flap to treat traumatic enophthalmos].
OBJECTIVE
To assess the vascularization of the laterally based pericranial flap and the feasibility of bony channel on the orbital lateral wall for  transplantation of the flap, and apply this flap to treat traumatic enophthalmos.


METHODS
Two formalin preserved cadaver specimens were anatomized  to observe the feasibility of pericranial flap transplantation through the bony channels on lateral orbital walls. Two fresh cadaver specimens were perfused  with latex and ink respectively to observe the possible blood supply to laterally based pericranial flaps. Two patients with unilateral old orbital fracture  were treated using this flap. The enophthalmos degrees were measured before and after operation to evaluate the effect of this therapy.


RESULTS
It  was feasible to transplant the pericranial flap into orbit through the bony channel on lateral orbital wall, reaching the medial wall and orbital floor. Vascular  perfusion did not reveal that the laterally based pericranial flap over the supra temporal line was vascularized by any axial vessel. The ink perfusion of one  side showed that the middle temporal artery extended deeply under the deep temporal fascia, but didn't cross the supra temporal line. The subgaleal  vascular plexus was observed obviously in the superficial layer of pericranial flap. The enophthalmos degrees of the two patients were respectively 5.35  mm and 6.86 mm prior to operation. They both showed desirable outcomes postoperation (<2 mm).


CONCLUSIONS
It is feasible to transfer the laterally  based pericranial flap into orbit through the lateral orbital wall channel. The laterally based pericranial flap is possibly vascularized by the subgaleal  vascular plexus. The primary treatment of traumatic enophthalmos using the laterally based pericranial flap is satisfactory.
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Yang
Y
He
Yi
Y
Zhang
Jin-gang
JG
An
D000328:Adult; D002102:Cadaver; D015841:Enophthalmos / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D009915:Orbit / Q000033:anatomy & histology* / Q000601:surgery; D009917:Orbital Fractures / Q000150:complications* / Q000473:pathology / Q000601:surgery; D010521:Periosteum / Q000637:transplantation*; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*