====== Hemicraniectomy skin incision ======

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The retro-auricular myocutaneous [[flap]] is a novel design of the [[incision]] and [[manipulation]] of the temporalis muscle during a hemicraniectomy in either traumatic brain injury or malignant middle cerebral artery (MCA) stroke
((Lyon K.A., Patel N.P., Zhang Y., Huang J.H., Feng D. Novel hemicraniectomy technique for malignant middle cerebral artery infarction. Operat Neurosurg. 2019;17(3):273–276.))
((Soto J.M., Feng D., Sun H., et al. Novel decompressive hemicraniectomy technique for traumatic brain injury. World Neurosurg. 2021;146:15–19.)).

{{::auricular_myocutaneous_flap_.jpg?200|}}
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Other options

{{::hemicraniectomy_skin_incision.png?400|}}

a) 

A starts at widow ’speak, similar to trauma flap, but with increased exposure by taking it posteriorly close to the inion, then turning sharply anteriorly and hugging the ear to preserve blood supply

b)

“T” incision. Less risk of flap ischemia.The“T” joins the midline incision behind
the coronal suture to preserve the [[STA]]
((Holland M, Nakaji P. Craniectomy: Surgical indications and technique. Operative Techniques in Neurosurgery. 2004; 7:10–15)).