Anatomy of Neuroplastic Surgery: The Surgical Anatomy of the Procedure

Introduction: Neuroplastic Surgery plays a pivotal role in addressing the challenges posed by postoperative cranial defects, stemming from various underlying pathologies. These defects not only compromise patient safety but also affect craniofacial aesthetics, leading to psychological distress. This manuscript reviews innovative techniques in Neuroplastic Surgery, such as the "Pericranial-Onlay Technique," "Component Separation of the Scalp," and the "Rectus Fascia Scalp Augmentation Technique." These approaches aim to restore normal cranial architecture, enhance aesthetics, and minimize complications. A comprehensive understanding of scalp anatomy and vascularization is essential for successful outcomes.

Methods: We describe the surgical anatomy as well as some of the operative techniques used in Neuroplastic Surgery

Results: The scalp's complex anatomy, including layers of skin, subcutaneous tissue, aponeurosis galea, loose areolar tissue, and pericranium, forms the foundation of Neuroplastic Surgery. The pericranium's robust blood supply makes it valuable in infection management and as an autologous solution.
Component separation minimizes complications by achieving tension-free scalp closure. It involves the dissection of fibrous retaining ligaments, separating superficial scalp layers from the deeper components. This approach takes advantage of the scalp's unique vascular network and maintains blood supply. The Pericranial-Onlay technique involves the elevation of a fasciocutaneous scalp flap containing a vascularized pericranium. This flap offers protection and support for intracranial contents while enhancing patient outcomes. The rectus-fascia scalp augmentation technique addresses challenges in patients with thin scalps. It utilizes autologous rectus fascia grafts to augment the scalp's structural integrity. This technique minimizes complications and offers long-term durability, ensuring patient satisfaction.

Conclusion : Neuroplastic Surgery continually evolves to optimize patient outcomes and minimize complications in cranial defect management. Innovative techniques discussed here underscore the promise of Neuroplastic Surgery in restoring cranial architecture, protecting intracranial contents, and enhancing patients' overall quality of life. A comprehensive understanding of scalp anatomy and vascularization remains fundamental in achieving success in these procedures.