Galeal Flaps

EDITORIAL COMMENT

This flap is based on the same principle as the temporoparietal fascial flap. Galea can be included when a thicker flap is desired. In ear reconstruction, the thinner fascial flap by itself is preferable.

Aponeurotic galeal flaps can be used for the correction of various facial deformities. They can be used not only for bulk but also to support skin and bone grafts through their increased vascularity.

INDICATIONS

Reconstruction of the Auricular Framework (1, 2)

See Chapter 96.

Cancer Surgery of the Head and Neck

Tumors of the orbital and frontal regions sometimes necessitate resection of soft tissue, including periosteum. A galeal flap with the superficial temporal artery as its pedicle can be rotated for coverage of the bone and as a vascular bed for a skin graft.

Hemifacial Atrophy

Patients with hemifacial atrophy have very thin skin and a poor blood supply. Management sometimes calls for segmental osteotomies of the maxilla and mandible with bone grafts. The galeal flap introduced subcutaneously ensures a successful surgical outcome because of increased volume of skin coverage and improvement in vascularity (Fig. 109.4).

Treacher Collins Syndrome

The cleft and hypoplasia of the orbital framework require a bone graft. The lack of soft tissue necessitates Z-plasties, skin grafts, or flaps. The galeal flap over the bone graft makes an increase in the thickness of soft tissue possible; consequently, a smoother bone contour can be achieved.

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