einstein (São Paulo). 22/Apr/2025;23:eAO1247.
Modified palatal flap via soft palate for skull base reconstruction
DOI: 10.31744/einstein_journal/2025AO1247
Highlights
■ The use of a pedicled palatal flap via the soft palate offers the advantage of low harvesting complexity.
■ The flap demonstrates highly positive metric data supporting its technical feasibility for reconstructing the skull base and adjacent regions.
■ Drilling is not necessary to enlarge the greater palatine foramen in this technique, which reduces the chances of injury to the vascular pedicle and surgical time.
ABSTRACT
Objective:
Given the importance of vascularized flaps, this study presents a new technique for reconstructing skull defects using a pedicled palatal flap via the soft palate.
Methods:
Five preserved cadaveric specimens were used to demonstrate the sequential steps involved in harvesting the palatal flap. In addition, 20 normal paranasal sinus computed tomography scans were analyzed to determine potential measurements of the flap (area, perimeter, greatest anteroposterior distance, and greatest transverse distance).
Results:
The average flap area in females and males was 11.8cm2 and 12.7cm2, respectively. The average perimeter in females and males was 13.5cm and 14.0cm, respectively. In all cases, the flap reached the infratemporal fossa and lower clivus.
Conclusion:
The palatal flap via the soft palate described in this study proved to be a metrically viable alternative in cadaveric and tomographic studies for use in endonasal surgeries, as well as for skull base and adjacent regions.
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