Novel use of unilateral galeopericranial flaps for closure of sino-orbital cutaneous fistulas

Sino-orbital cutaneous fistulas are a well-documented complication of orbital exenteration and sinonasal carcinoma resection. However, these defects remain a difficult to close due to persistent mucopurulent drainage and previous irradiation. We describe a novel approach for closure of sino-orbital cutaneous fistulas in 2 patients using a galeopericranial flap. The galeopericranial flap is ideal due to its thin, pliable nature and predictable, abundant vascularity. The flap has been used successfully in a variety of skull base and ophthalmologic surgeries. Additionally, the galeopericranial flap obviates the need for a more cosmetically disfiguring closure. Both patients defects have remained closed at follow-up with excellent cosmetic results.