Development of pericranial flap
When the frontal sinus and/or anterior cranial base are to be reconstructed, it is advisable to develop a pericranial flap.
An anterior-based pericranial flap is very versatile and can be used in sealing of the nasal cavity in frontal sinus reconstruction, for closure, or obliteration of skull base defects, etc.
The pericranial flap is vascularized by the deep branches of the supraorbital and supratrochlear arteries which course between the galea-frontalis muscle layer and the pericranium. In order not to devascularize the flap during preparation, these layers must not be separated too far anteriorly and downwards.
After supraperiosteal dissection of the coronal flap, the pericranium is incised and elevated from the skull.
To develop a large rectangular flap the incisions through the pericranium are made bilaterally along the superior temporal lines from the anterior to posterior extent of the exposed surface as illustrated.