Takumi Ichiro, Akimoto Masataka, Hironaka Kouhei, Adachi Koji, Kon Takashi, Matsumori Takashi, Tanaka Yuichiro, Morita Akio
Department of Neurosurgery, St. Marianna University School of Medicine.
Department of Neurological Surgery, Nippon Medical School Musashi Kosugi Hospital.
Neurol Med Chir (Tokyo). 2018 Aug 15;58(8):350-355. doi: 10.2176/nmc.tn.2017-0252. Epub 2018 Jul 12.
This technical note aims to demonstrate the usefulness, indications and its limitations of augmentation technique by bipedicle galeo-pericranial rotation flap and by monopedicle galeo-pericranial flap, both in STA (superficial temporal artery) branch compromised hosts in salvage frontotemporal cranioplasty. Although these flaps are not always idealistically vascularized owing to accidental injuries to the STA branches during previous surgeries, they are properly augmenting after salvage frontotemporal craniotomy when infection is not active. The procedure is indicated for salvage frontotemporal craniotomy when vasculature is needed at the surgical site, such as beneath the skin incision line in a thin injured scalp, onto the titanium plates or beneath the fragile fibrous scar. We do not apply this technique by neurosurgeons alone where infection is active or if the host is irradiated. This technique is recommended as a reconstructive aesthetic neurosurgical procedure. It is a 'neurosurgeon-friendly' simple procedure, as it does not require any special tools or complicated techniques.
本技术说明旨在展示双蒂帽状腱膜 - 颅骨膜旋转皮瓣和单蒂帽状腱膜 - 颅骨膜皮瓣在颞浅动脉(STA)分支受损的额颞部颅骨修补术中的实用性、适应症及其局限性。尽管由于先前手术中颞浅动脉分支意外受伤,这些皮瓣的血供并不总是理想,但在额颞部颅骨切开术后感染不活跃时,它们能起到适当的修补作用。该手术适用于手术部位需要血管供应的额颞部颅骨切开术,比如在薄的受伤头皮的皮肤切口线下方、钛板上或脆弱的纤维瘢痕下方。当感染活跃或宿主接受过放疗时,我们不单独由神经外科医生应用此技术。该技术作为一种重建性美学神经外科手术被推荐。它是一种“对神经外科医生友好”的简单手术,因为它不需要任何特殊工具或复杂技术。