A feature of the temporalis flap is the sunken contour left behind. This group from Japan present a variation for filling defects for which we would traditionally use a temporalis muscle containing. The laterally based peri-cranial flap they present uses the vessels that run with the temporoparietal facia that supply the pericranium above the temporalis muscle. This allows them to leave the temporalis muscle in situ and thus prevent the concavity above the zygoma. They compare two case series in the paper one for the ‘conventional pericranial flap’ and the other for the ‘muscle sparing pericranial flap’. The results presented showed comparable reconstructive time, complications and hospital stay while reducing the cosmetic defect caused by harvesting the muscle with the flap. The presented technique seems to provide a simple modification to a well-established technique that would prevent one of its disfiguring side-effects. 

Feasibility and advantage of a muscle-sparing laterally based pericranial flap.
Yano T, Okazaki M, Tanaka K, et al.
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Stuart Burrows

FRCS (ORL-HNS), Wellington Regional Hospital, Newtown, Wellington, New Zealand.

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