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CC BY-NC 4.0 · Arch Plast Surg 2018; 45(02): 118-127
DOI: 10.5999/aps.2017.00360
Original Article

Superficial temporal artery flap for reconstruction of complex facial defects: A new algorithm

Authors

  • Tarek M. Elbanoby

    Department of Plastic and Burn Surgery, Al-Azhar University, Cairo, Egypt
    Craniofacial Unit, Naser Institute Hospital, Cairo, Egypt

  • Serag M. Zidan

    Department of Plastic and Burn Surgery, Al-Azhar University, Cairo, Egypt

  • Amr M. Elbatawy

    Department of Plastic and Burn Surgery, Al-Azhar University, Cairo, Egypt

  • Gaber M. Aly

    Department of Plastic and Burn Surgery, Al-Azhar University, Cairo, Egypt

  • Khallad Sholkamy

    Department of Plastic and Burn Surgery, Al-Azhar University, Cairo, Egypt

This article was presented by the first author at the 16th Congress of the International Society of Craniofacial Surgery (ISCFS) Japan on September 2015, in Tokyo, Japan.
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Background A variety of island flaps can be based on the superficial temporal artery with variable tissue composition. They can be used for defect reconstruction, cavity resurfacing, facial hair restoration, or contracture release.

Methods Seventy-two patients underwent facial reconstruction using a superficial temporal artery island flap from October 2010 to October 2014. The defects had various etiologies, including trauma, burns, tumors, exposed hardware, and congenital causes. We classified the patients by indication into 5 groups: cavity resurfacing, contracture release, facial hair restoration, skin coverage, and combined. The demographic data of the patients, defect characteristics, operative procedures, postoperative results, and complications were retrospectively documented. The follow-up period ranged from 24 to 54 months.

Results A total of 24 females and 48 males were included in this study. The mean age of the patients was 33.7±15.6 years. The flaps were used for contracture release in 13 cases, cavity resurfacing in 10 cases, skin coverage in 17 cases, facial hair restoration in 19 cases, and combined defects in 13 cases. No major complications were reported. Conclusion: Based on our experiences with the use of superficial temporal artery island flaps, we have developed a detailed approach for the optimal management of patients with composite facial defects. The aim of this article is to provide the reader with a systematic algorithm to use for such patients.

Keywords

Face - Reconstructive surgical procedures - Algorithms - Hair - Surgical flaps

I want to thank Dr. Mahmoud Eldosoky for his contribution with the illustration.


This article contains Supplemental Figs. S1-S4.


Supplementary Material

    Orbital reconstruction (A) Preoperative: a 25-year-old male patient with extensive periorbital skin loss and a ruptured globe. (B) Postoperative: after bone restoration and soft tissue reconstruction. (C) After debridement and excision of the globe remnant with fixation with microplates all around the orbital rim. (D) Island temporoparietal flap skin island with a temporal fascia extension; the skin island was for the lower eyelid and malar and infraorbital cheek region, while the temporal fascia extension was for eye socket resurfacing with coverage by a splitthickness skin graft. (E) After tunneling of the flap. (F) Postoperative results (https://doi.org/10.5999/aps.2017.00360).

  • Supplementary material (PDF)

Supplemental Fig. S2.

    Palate reconstruction (A) Harvesting of a temporoparietal osteofacial flap (full-thickness vascularized bone). (B) Insetting of the flap (fascia above the bone as the nasal layer with rigid fixation of bone graft with bony palate). (C) Reinforcement of the fascial extension as the oral layer down the bone graft and coverage of the flap with a split-thickness skin graft. (D) Immediate postoperative result (https://doi.org/10.5999/aps.2017.00360).

  • Supplementary material (PDF)

Supplemental Fig. S3.

Supplemental Fig. S4.

    Eyebrow reconstruction (A) A 7-year-old male patient with craniofacial cleft and congenital alopecia of the right eyebrow, and the design of the flap and proposed eyebrow. (B) After harvesting of the flap, note that a good tunnel was mandatory to avoid congestion (the white arrows refer to the superficial temporal artery and its two branches). (C) Immediate postoperative photograph with direct closure of the donor site (https://doi.org/10.5999/aps.2017.00360).

  • Supplementary material (PDF)


Publication History

Received: 21 February 2017

Accepted: 18 October 2017

Article published online:
22 May 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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