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Scalp laceration
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
The galea aponeurotica is a dense, tendon-like structure that covers the skull. It connects to the frontalis muscle anteriorly and the occipitalis muscle posteriorly. It is important to evaluate this structure for lacerations, as failure to approximate lacerations of the galea aponeurotica can lead to cosmetic deformities due to asymmetric frontalis muscle elevation. Additionally, this serves as a layer to protect the skull from skin infections.
Grafts and Local Flaps in Head and Neck Cancer
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The scalp has five distinct anatomical layers. From superficial to deep, these are the skin, subcutaneous connective tissue, muscle or aponeurosis (galea), loose areolar tissue and pericranium. The skin of the scalp is the thickest on the human body, ranging from 3 mm to 8 mm. Beneath the skin, the subcutaneous tissue contains the vessels and nerves supplying the scalp. Deep to this is the musculoaponeurotic layer consisting of the frontalis muscle anteriorly and the occipitalis muscle posteriorly. These muscles are connected by an aponeurotic layer (the galea aponeurotica). Laterally, this aponeurosis is connected to the subcutaneous musculoaponeurotic system (SMAS) of the face. The layer of loose areolar tissue deep to this, also known as the inominate fascia, is an avascular plane. Owing to this, most local flaps of the scalp are raised at this level because it is easy to dissect and relatively bloodless, thus making scalp flaps fasciocutaneous rather than cutaneous. The deepest layer is the pericranium (the periosteum of the skull) which is firmly adherent to the underlying bone. However, it can be raised and turned over on itself to form a pericranial flap.27 This is viable tissue that can cover exposed bone and is capable of taking a skin graft. Laterally, the pericranium is continuous with the deep temporal fascia overlying the temporalis muscle.
Access surgery
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Madangopolan Ethunandan, Barrie T Evans, Dorothy A Lang
The scalp has five layers (Figure 36.1a and b):SkinConnective tissue (subcutaneous)Aponeurosis (galea) connecting the paired frontalis muscle anteriorly and occipitalis muscle posteriorlyLoose areolar connective tissue (subgaleal plane)Pericranium
Dry needling as a novel intervention for cervicogenic somatosensory tinnitus: a case study
Published in Physiotherapy Theory and Practice, 2022
Aaron Womack, Raymond Butts, James Dunning
Dry needling was applied during all treatment sessions with minimal variation of location with one exception. During the 4th treatment, which took place eight days after the initial clinical assessment, the patient reported no headache or tinnitus symptoms. However, she experienced a headache 24-hours earlier and requested treatment to address the occipital region. In addition to an upper cervical HVLA thrust manipulation, targeting the C1-C2 facet joints, she received dry needling to the sensitive portion of the occipitalis muscle. Needles were left in situ for 20 minutes with manual stimulation (i.e. unidirectional winding) every 3–4 minutes. Although the patient reported reduced tinnitus symptoms, she did not note an improvement in intermittent headache symptoms following the treatment.
Galea vs periosteum: impact of excision depth on outcomes for cutaneous squamous cell carcinoma of the scalp
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Christopher F. Brewer, Reema Chawla, Animesh J. K. Patel
Cases where the cSCC was located in an area of the scalp without underlying galea (e.g. over frontalis and occipitalis muscle), along with those which had no documentation regarding the primary excision depth or were excised down to bone were excluded. In addition, cases which had cSCC recurrence without adequate reporting/imaging detailing the site of the recurrence were also excluded (as this precluded accurate reporting of local recurrence).