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Abstract：
The objective of the present study was to describe and evaluate the feasibility, mobility, and surface area provided by the simple and extended transorbital pericranial flap (TOPF). Furthermore, we compared this novel technique with the current practice of pericranial flap harvesting and insetting techniques. We also studied the adequacy of the TOPF in the reconstruction of postoperative anterior cranial fossa (ACF) defects.
The TOPF was performed bilaterally in 5 alcohol-preserved, latex-injected human cadaveric specimens. The TOPF was harvested in 2 stages: the orbitonasal stage and the cranial stage. For the orbitonasal stage, a transorbital superior eyelid approach was used. We have described 2 harvesting techniques for creating 2 distinct TOPF types (simple and extended) according to the main vascular pedicle. The superficial flap areas offered by the simple and extended TOPF and the traditional bicoronal pericranial flap were calculated and compared. The distances from the supratrochlear and supraorbital arteries to specified anatomical landmarks were also measured. Additionally, the ACF defect area of relevant surgical cases performed using endoscopic transcribriform approaches were measured on immediate postoperative computed tomography head scans using radiological imaging software.
The harvest of both the simple and the extended TOPFs was efficient. As expected, the areas offered by simple and extended TOPFs were smaller than that offered by the traditional bicoronal flap. However, the surface area offered by either the simple or extended TOPF provides sufficient coverage for most ACF defects. A high spatial distribution was observed between the vascular pedicles and their respective foramen or notch.
The TOPF represents a novel harvesting, tunneling, and insetting technique that offers a large, versatile, pedicled flap for coverage of most standard ACF defects after endoscopic surgery.
The TOPF was performed bilaterally in 5 alcohol-preserved, latex-injected human cadaveric specimens. The TOPF was harvested in 2 stages: the orbitonasal stage and the cranial stage. For the orbitonasal stage, a transorbital superior eyelid approach was used. We have described 2 harvesting techniques for creating 2 distinct TOPF types (simple and extended) according to the main vascular pedicle. The superficial flap areas offered by the simple and extended TOPF and the traditional bicoronal pericranial flap were calculated and compared. The distances from the supratrochlear and supraorbital arteries to specified anatomical landmarks were also measured. Additionally, the ACF defect area of relevant surgical cases performed using endoscopic transcribriform approaches were measured on immediate postoperative computed tomography head scans using radiological imaging software.
The harvest of both the simple and the extended TOPFs was efficient. As expected, the areas offered by simple and extended TOPFs were smaller than that offered by the traditional bicoronal flap. However, the surface area offered by either the simple or extended TOPF provides sufficient coverage for most ACF defects. A high spatial distribution was observed between the vascular pedicles and their respective foramen or notch.
The TOPF represents a novel harvesting, tunneling, and insetting technique that offers a large, versatile, pedicled flap for coverage of most standard ACF defects after endoscopic surgery.
摘要：
本研究的目的是描述和评估可行性，移动性,和由简单和延伸的经眶颅周皮瓣（TOPF）提供的表面积。此外，我们将这项新技术与目前的颅骨周围皮瓣获取和嵌入技术进行了比较。我们还研究了TOPF在术后前颅窝（ACF）缺损重建中的充分性。
TOPF是在5种酒精防腐的情况下进行的，乳胶注射的人体尸体标本。TOPF分为两个阶段：眶鼻期和颅期。对于眶鼻部阶段，采用经眶上眼睑入路。我们已经描述了根据主要血管蒂创建2种不同TOPF类型（简单和扩展）的2种收获技术。计算并比较了简单和扩展的TOPF与传统的双冠状颅骨皮瓣提供的浅表皮瓣面积。还测量了从滑车上动脉和眶上动脉到指定解剖标志的距离。此外,在术后即刻的计算机断层扫描头部扫描中,使用放射成像软件测量了使用内窥镜转录型入路进行的相关手术病例的ACF缺损面积.
简单和延长的TOPF的收获都是有效的。不出所料,简单和扩展的TOPF提供的区域比传统的双冠状皮瓣提供的区域小。然而,简单或扩展的TOPF提供的表面积为大多数ACF缺陷提供了足够的覆盖。在血管蒂及其各自的孔或凹口之间观察到高空间分布。
TOPF代表了一种新颖的收获，隧道,和镶嵌技术，提供了一个大的，多才多艺，带蒂皮瓣覆盖内窥镜手术后的大多数标准ACF缺损。
TOPF是在5种酒精防腐的情况下进行的，乳胶注射的人体尸体标本。TOPF分为两个阶段：眶鼻期和颅期。对于眶鼻部阶段，采用经眶上眼睑入路。我们已经描述了根据主要血管蒂创建2种不同TOPF类型（简单和扩展）的2种收获技术。计算并比较了简单和扩展的TOPF与传统的双冠状颅骨皮瓣提供的浅表皮瓣面积。还测量了从滑车上动脉和眶上动脉到指定解剖标志的距离。此外,在术后即刻的计算机断层扫描头部扫描中,使用放射成像软件测量了使用内窥镜转录型入路进行的相关手术病例的ACF缺损面积.
简单和延长的TOPF的收获都是有效的。不出所料,简单和扩展的TOPF提供的区域比传统的双冠状皮瓣提供的区域小。然而,简单或扩展的TOPF提供的表面积为大多数ACF缺陷提供了足够的覆盖。在血管蒂及其各自的孔或凹口之间观察到高空间分布。
TOPF代表了一种新颖的收获，隧道,和镶嵌技术，提供了一个大的，多才多艺，带蒂皮瓣覆盖内窥镜手术后的大多数标准ACF缺损。
