The lateral branch of the supraorbital nerve has no branches within 10 mm after exiting the supraorbital foramen and notch and courses on the
pericranium with an angle with the supraorbital margin of 74 [+ or -] 3[degrees] (68-80[degrees])[53].
Significant effort has been taken in designing repairs for defects of this type, to include soft-tissue flaps (including
pericranium, galea aponeurotica, and frontalis or temporalis muscle) or to perform flee-tissue transfer.
Supraperiosteal scalp flaps were then anteriorly and posteriorly raised, allowing the
pericranium and temporalis fascia to remain fixed.
With the patient under general anesthesia, the expander was placed through a small incision in the healthy scalp beyond the donor area by creating a pocket between the galea aponeurotica and the
pericranium. Incision for insertion for expander was always radial to the expander.
Free skin grafts reconstruction requires an intact
pericranium to supply vascularization to the graft.
The head is turned 30 degrees and a frontotemporal scalp incision is made from the level of the lower en of the tragus to the contralateral superior temporal line with anterior reflection of the
pericranium. The scalp flap is reflected anteriorly.
This provided for a large anterior flap, which could be easily retracted to achieve wide exposure of the underlying
pericranium and fascia.
Through a retromastoid incision the muscle, fascia, and
pericranium are dissected away from the calvaria.
The grafting material may be Gore-Tex, fascia lata, or
pericranium. The wound is then closed.
