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J Reconstr Microsurg 2006; 22(6): 399-406
DOI: 10.1055/s-2006-947693
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Coronal-Posterior Approach for Face/Scalp Flap Harvesting in Preparation for Face Transplantation

Maria Siemionow1 , Frank Papay1 , Yalcin Kulahci1 , Risal Djohan1 , Warren Hammert1 , Mark Hendrickson1 , James Zins1
  • 1Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH
Further Information

Publication History

Accepted: May 8, 2006

Publication Date:
07 August 2006 (online)

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ABSTRACT

This report describes the development of a new technique for harvesting facial allograft for facial transplantation. The coronal-posterior surgical approach for facial/scalp flap harvesting from donor cadavers has been developed to allow extended length to the neurovascular bundles utilized in facial composite allograft transplantation. Cadaveric anatomic dissections were performed to harvest facial/scalp flaps via a posterior-coronal approach. Supraorbital and infraorbital neurovascular bundle lengths were extended by osteotomy of the cranial/orbital bone. The mental nerve lengths were extended into the inferior alveolar neurovascular bundle utilizing a sagittal split ramus osteotomy. This surgical approach extends the length of these craniofacial nerves for future neurorrhaphy. The mean length of the supraorbital, infraorbital, and mental nerves was 3.52 ± 0.31 cm, 4.65 ± 0.20 cm, 5.6 ± 0.14 cm, respectively. Based on anatomical dissection in this cadaver study, the authors introduce a new technique for facial/scalp flap harvesting that extends the neurovascular bundles of sensory nerves of the anterior craniofacial skeleton.

KEYWORDS

Coronal-posterior approach - cadaver dissection - face/scalp flap harvesting

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Maria SiemionowM.D. Ph.D. D.Sc. 

Department of Plastic Surgery, Cleveland Clinic

9500 Euclid Avenue/Desk A-60, Cleveland, Ohio 44195

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