Use of a galeopericranial flap for the reconstruction of anterior cranial base defects

Background: To evaluate the efficacy of using a galeopericranial flap for reconstruction of anterior cranial base defects. Methods: In Linkou Chang Gung Memorial Hospital from February 1994 to November 2003, 25 patients who had tumors of the skull base underwent craniofacial resection, and a galeopericranial flap was used to reconstruct the anterior cranial base defect. The galeopericranial flap was developed and based on at least 1 side of the supraorbital or supratrochlear arteries and veins; it was only raised from the scalp after the tumor had been removed. It was then turned inwardly and intracranially and was transposed to lie between the skull base bone and the dura. No free skin or bone grafts were used. Results: Two patients experienced flap failure, and salvage was subsequently performed using a free vastus lateralis flap for skull base repair. Thus, the flap failure rate was 8% (2/25). Conclusions: The delicate nature and great pliability of a galeopericranial flap make it unique and competent for reconstructions of anterior skull base defects. Its ready availability, valid strength, and sufficient axial blood supply provide a satisfactory barrier for isolating the cranial cavity from the underlying respiratory tract, with minimal morbidity and mortality.