Transparapharyngeal and transpterygoid transposition of a pedicled occipital galeopericranial flap: A new flap for skull base reconstruction

Abstract

Objectives: We present the anatomic and cadaveric foundations for novel modifications of the occipital galeopericranial flap for reconstruction of ventral skull base defects. Study Design: Anatomic description. Methods: Using cadaveric dissections and measurements, we investigated the feasibility of transposing pedicled occipital galeopericranial flaps into the nasal cavity and skull base. Two fresh and five preserved human specimens were dissected. Results: Pedicled occipital flaps were transposed into the nasal cavity via a transparapharyngeal-transpterygoid corridor into the nasopharynx. It was demonstrated that the pedicled occipital galeopericranial flap reaches the anterior skull base. Conclusions: Pedicled occipital flaps transposed into the nasal cavity can reach the anterior skull base and provide another option for vascularized reconstruction in selected patients. © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.