Authors: Mauricio López-Chacón, María Jesús Rojas-Lechuga, Natalia Arango, Sara Jubés, Mohammed Albouq and Isam Alobid.

Journal: Acta Otorrinolaringológica Española (English edition). Published online October 22, 2026.

Study design: Cadaveric anatomical comparison, six fresh human head specimens.

DOI: 10.1016/j.otoeng.2026.512411 · PubMed (PMID 42914087).

Key findings

The study evaluated endoscopic harvesting of an inferiorly based pericranial flap through horizontal (n = 3) versus vertical (n = 3) frontal incisions, using suprabrow suprapericranial dissection.

• Mean flap length: 98.3 mm for horizontal and 105 mm for vertical incisions (p = 0.164).
• Mean flap width: 71 mm versus 77 mm, respectively (p = 0.700).
• Neither flap dimension differed significantly by incision orientation.
• The supratrochlear and supraorbital neurovascular pedicles were preserved in all preparations.

Why this matters for skull base surgery

The pericranial flap is a useful vascularized reconstructive option for anterior skull base defects, especially when a nasoseptal flap is unavailable. These anatomical results suggest both incision orientations can provide similar flap dimensions, allowing incision selection to take aesthetic considerations into account. The small sample and absence of clinical outcomes limit broader conclusions.