{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:31:47Z","timestamp":1788654707480,"version":"build-2803163510"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T00:00:00Z","timestamp":1592870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To describe the magnetic resonance imaging (MRI) characteristics of the pericranial flap, changes in the pericranial flap thickness over time, presence of frontal sinus opacification, and presence of frontal lobe herniation into the nasal cavity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventeen consecutive endoscopic craniofacial resections with pericranial flap reconstruction performed at a tertiary hospital from 2010 to 2019 were reviewed. Sixty\u2010eight serial MRI scans were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All pericranial flaps consistently featured a homogenous appearance on T1\u2010weighted sequence and enhanced with contrast. On T2\u2010weighted sequence, the skull base reconstruction demonstrated four layers of alternating hypo\u2010 and hyperintensity, which corresponded with the inlay synthetic graft or neodura (hypointense), loose areolar tissue (hyperintense), fibrous pericranium (hypointense), and nasal mucosa or granulation tissue (hyperintense). The mean pericranial flap thickness was 9.9\u2009mm. In thicker flaps, the loose areolar layer contributed the bulk of the thickness. Of 13 patients who underwent three or more serial MRI scans, 11 flaps (84.6%) were stable and two (15.4%) had &gt;50% reduction in their original thickness over time. Thirteen of 17 (76.5%) patients had frontal sinus opacification on follow\u2010up. None developed frontal sinus mucoceles or frontal lobe herniation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The pericranial flap has a distinctive MRI appearance, especially on T2\u2010weighted sequence. The thickness of the flap remains relatively stable over time for most patients even following radiotherapy. It is a sturdy flap that is able to support the frontal lobe. Frontal sinus obstruction is common, although complications from this appear to be rare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E90\u2013E97, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28735","type":"journal-article","created":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T18:26:39Z","timestamp":1592936799000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Magnetic Resonance Imaging Study of the Pericranial Flap and Its Local Effects Following Endoscopic Craniofacial Resection"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7534-2545","authenticated-orcid":false,"given":"Xinni","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sein","family":"Lwin","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ting","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yew Kwang","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199006000-00011"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20022"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1453"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3853"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21020"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.10.JNS09406"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000365620.59677.FF"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003676"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813520290"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.01.004"},{"issue":"3","key":"e_1_2_7_12_1","first-page":"457","article-title":"Brain herniation after endoscopic transnasal resection of anterior skull base malignancies","volume":"11","author":"Battaglia P","year":"2015","journal-title":"Neurosurgery"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.28735","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28735","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.28735","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28735","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T15:09:33Z","timestamp":1693580973000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.28735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,23]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1002\/lary.28735"],"URL":"https:\/\/doi.org\/10.1002\/lary.28735","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,23]]},"assertion":[{"value":"2020-02-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}