Axial subcutaneous scalp flaps in the reconstruction of the anterior cranial fossa.

A major concern following combined craniofacial resection of neoplasms involving the floor of the anterior cranial fossa is the creation of a watertight separation between the contents of the anterior cranial fossa and the upper aerodigestive tract. The reconstructive technique should satisfy several goals, which we will outline. The axial subcutaneous scalp flap meets these goals and has proved to be useful in reconstruction of the anterior skull base. We used the axial subcutaneous scalp flap for this purpose in three patients. Herein, we report our experience and emphasize the importance of the vascular pattern of the anterior scalp.