Utility of the pericranial flap in frontal sinus and anterior cranial fossa trauma

Complex injuries to the frontal bar of the upper face can cause significant damage to the anterior cranial fossa. One of the biggest challenges in the repair of such injuries is the prevention of a cerebrospinal fluid leak and separation of the brain from the nasal cavity. Although many autogenous and alloplastic materials can be used for this purpose, the pericranial flap offers a viable alternative. This axially based flap is readily available, does not require an extra harvest site, and can be fashioned appropriately to obliterate the frontal sinus and/or line the anterior cranial base to decrease the possibility of cerebrospinal fluid leaks. The authors’ experience with this flap in complex frontal sinus and anterior cranial fossa injuries is described.