Reconstruction of the Scalp, Forehead, Calvarium, Skull Base, and Midface Flashcards
How many regional flaps are in the calvarial?
only three regional flaps (pericranium, temporoparietal fascia, and temporalis muscle)
The blood supply of the forehead and scalp
supraorbital, supratrochlear, superficial temporal (ST),
posterior auricular, and occipital vessels.
The sensory nerves
the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, lesser occipital, and greater occipital
nerves.
defect up to 5 cam can closed primarly
F No greater than 3 cm in diameter
Techniques that can utilise to facilitates primary closure
First, the resection
can be designed so that the closure is oriented perpendicular to the
relaxed skin tension lines; this tends to be in a sagittal direction on
the scalp and in a transverse direction on the forehead. Second, wide
undermining in the subgaleal layer along the circumference of the
defect can reduce tension. Finally, galeal scoring is an adjunctive
technique that can increase scalp pliability and reduce closure tension.
Scores deeper than the galea will disrupt the random pattern
blood supply of the scalp
T
After burring the outer table the skin graft should put in delayed fashion
F This can be performed
immediately or with an intermediate stage using a dermal substitute
areas of the scalp with laxity
the parietal and temporal regions
What is the back grafting
Reconstruction of larger defects may require
elevating the local flap in the subgaleal plane and maintaining the
pericranium so that the donor site can then be closed with a skin graft
The draw back of the Orticochea flap?
unpopular because of the
high rate of partial flap necrosis
The aesthetic subunit principle
should be followed to make the reconstruction as inconspicuous as
possible. in forehead reconstruction
T
The most suitable donor site for skin graft to forhead
skin grafts should be harvested from a
location above the clavicles to achieve a good color match
Contraindications in using tissue expansion in forehead and scalp surgery
It is less germane in the oncologic setting when there is typically an urgent need for resection,
a history of radiation therapy or the anticipated need for adjuvant radiation precludes the use of tissue expansion,
tissue expansion provide hair-bearing tissue of a similar thickness
T
The temporoparietal fascia! flap and temporalis muscle flap can
be used for defects within or adjacent to the temporal area or lateral
forehead
T
Recipient vessels should have a similar caliber in free flap
T
the anastomosis should be
performed above the tragal notch where the vessels emerge
from the parotid.
F the anastomosis should be
performed at the level of the tragal notch where the vessels emerge
from the parotid.
pedicle length required to travel from the neck to the scalp almost
always necessitates the use ofa vein graft
T
age is not a contraindication
to microsurgical scalp reconstruction
T
The atrophy of the muscle flap will accelerate with radiotherapy
T
Flaps with a skin paddle may be preferred in situations where the flap is covering a cranioplasty.
T
Calvarial reconstruction is usually recommended for any full-thickness defect greater than 10 cm
F Calvarial reconstruction is usually recommended for any full-thickness defect greater than 6 cm
The type of alloplastic material used was not found to be
an independent risk factor for complications
T
What is the thickest bone in the skull ?
he parietal bone
The pariental graft site should not extend any
further medially than 2 cm lateral to midline
F 1.5