Temporal-based pericranial flaps for orbitofrontal Dural repair: A technical note and Review of the literature

•Lateral based flaps are proposed as an alternative for dural repair in orbitalfrontal approaches.•Two surgical cases with follow up are presented.•Relevant anatomy and surgical technique is reviewed.•A review of current literature and historical considerations are included.

IntroductionPericranial flaps are widely used for dural repair as they are easily accessible and have a lower rate of infection than artificial grafts. Vascularized flaps increase the rate of successful dural closure and minimize the risk of cerebrospinal fluid leak and infection. However, regional access can be limited by the necessity of maintaining the vascularized pedicle. Classically, frontal-based vascularized flaps have been used for dural repair after orbitalfrontal approaches to large anterior fossa meningiomas. We present an alternative lateral temporal-based flap for dural repair in orbitalfrontal approaches.Surgical Technique & MethodsTwo cases are presented where a temporal-based flap was used. In the two cases presented, we found that temporal-based pericranial flaps can be harvested with preservation of blood supply and can achieve watertight dural closure. The surgical technique and relevant anatomy are described. Surgical results and clinic follow up are reported.ConclusionsA temporal-based pericranial flap represents an alternative vascularized pedicle flap to the classic frontal-based pericranial flap used in orbitofrontal dural repair. In certain clinical settings, the temporal-based flap may be preferable.