Everted Pedicled Temporalis Fascial Flap to Augment Pedicled Pericranial Flap for Lax Duraplasty in Decompressive Craniotomy: A Cost-Effective Procedure

• Main Authors: Rajesh Bhosle, Shamshuddin Sr Patel, Dimble Raju, Nabanita Ghosh, Prasad Krishnan
• Format: Article
• Language: English
• Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2021-04-01
• Series: Journal of Neurosciences in Rural Practice
• Subjects: decompressive craniotomy; pericranium; temporalis fascia; duraplasty; pedicled flap; cranioplasty
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1726661

Decompressive craniotomy is a commonly performed surgery to relieve raised intracranial pressure. At the end of the procedure, it is the convention to cover the exposed brain by performing a lax duraplasty which allows for both brain expansion and provides protection to the underlying parenchyma. Various commercially available dural substitutes are used for this purpose. These have the drawback of being both expensive and nonvascularized. We propose a technique of using pericranium along with everted temporalis fascia (both being locally harvested vascularized pedicle flaps) that can suffice in a vast majority of cases for covering the brain.