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Updated: Jun 16, 2026
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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Modified trans-oral approach with an inferiorly based flap
Wajd N Al-Holou1, Paul Park, Anthony C Wang
1Department of Neurosurgery, University of Michigan Health System, 1500 E. Medical Center Drive, Taubman Center, Ann Arbor, Michigan 48109-5338, USA.
Summary
This study introduces an inferiorly based flap for the trans-oral approach, enhancing surgical access to anterior craniocervical junction pathologies. This technique offers improved exposure and safety, reducing complications for patients.
Area of Science:
- Neurosurgery
- Otolaryngology
- Head and Neck Surgery
Background:
- The trans-oral approach provides direct access to anterior craniocervical junction pathologies.
- Traditional midline incisions can be burdensome and limit lateral surgical exposure.
Purpose of the Study:
- To evaluate the safety and efficacy of an inferiorly based flap in the trans-oral approach for anterior craniocervical junction pathologies.
- To assess the impact of this flap on surgical exposure and patient morbidity.
Main Methods:
- Retrospective review of nine patients undergoing trans-oral surgery with an inferiorly based flap.
- Pathology sites ranged from the clivus to C2; surgical exposure extended from the clivus to C3.
Main Results:
- No vascular or neurologic complications were observed.
- No patients developed cerebrospinal fluid fistula, pseudomeningocele, or meningitis postoperatively.
- The U-shaped flap provided adequate exposure from the lower clivus to C3, improved lateral access, and facilitated mucosal closure.
Conclusions:
- The trans-oral approach utilizing an inferiorly based flap is safe and effective for anterior craniocervical junction pathologies.
- This technique minimizes oropharyngeal and neurologic morbidity.
- The flap enhances surgical field clarity and improves closure outcomes.