The temporoparietal fascial flap in head and neck reconstruction: The workhorse from above

Flaps from temporal region have been used for mid face, orbital and peri-orbital reconstruction. The knowledge of the vascular anatomy of the region helps to dissect and harvest the muscle/fascia/skin/combined tissue flaps from that region depending upon the requirement. Suprastructure maxillectomy defects are usually covered with free flaps to fill the cavity. Here we report an innovative idea in which a patient with a supra structure maxillectomy with external skin defect was covered with chimeric flap based on the parietal and frontal branches of superficial temporal artery and the temporalis muscle flap based on deep temporal artery.

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“…Joseph et al . [ 6 ] described temporoparietal fascia flap as “work horse from above” for head and neck reconstruction. Andrew et al .…”

Section: Discussionmentioning

confidence: 99%

Chimeric superficial temporal artery based skin and temporal fascia flap plus temporalis muscle flap - An alternative to free flap for suprastructure maxillectomy with external skin defect

Jaiswal

Yadav

Shankhdhar

et al. 2011

Indian J Plast Surg

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“…The deep temporal fascia is continuous with the pericranium superiorly, directly covers the temporalis muscle, and is separated from the TPF above by a loose areolar tissue layer. 2,10,20,29,36 The TPF is supplied by the STA, which courses through it. TPF drainage is provided by the superficial temporal vein (STV) located slightly superficial to the STA.…”

Section: Anatomy and Nomenclaturementioning

confidence: 99%

Pedicled temporoparietal fascial flap for combined revascularization in adult moyamoya disease

Rāviņa¹,

Rennert

Strickland

et al. 2019

Journal of Neurosurgery

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Moyamoya disease (MMD) is a progressive, idiopathic cerebrovascular occlusive disease. Various revascularization techniques including direct, indirect, and combined microvascular bypasses have been described. This article presents a modified revascularization technique for MMD utilizing a pedicled temporoparietal fascial flap (TPFF) for combined revascularization. This technique combines a large area of coverage for indirect revascularization with the benefits of a direct bypass. The pedicled TPFF also benefits from intact venous drainage to minimize the risk of flap swelling that could result in complications from mass effect.

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Vascular mapping of the retroauricular skin – proposal for a posterior superior surgical incision for transcutaneous bone-conduction hearing implants

Perényi

Bere

Jarabin

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundPassive transcutaneous osseointegrated hearing implant systems have become increasingly popular more recently. The area over the implant is vulnerable due to vibration and pressure from the externally worn sound processor. Good perfusion and neural integrity has the potential to reduce complications. The authors’ objective was to determine the ideal surgical exposure to maintain perfusion and neural integrity and decrease surgical time as a result of reduced bleeding.MethodsThe vascular anatomy of the temporal-parietal soft tissue was examined in a total of 50 subjects. Imaging diagnostics included magnetic resonance angiography in 12 and Doppler ultrasound in 25 healthy subjects to reveal the arterial network. Cadaver dissection of 13 subjects formed the control group. The prevalence of the arteries were statistically analyzed with sector analysis in the surgically relevant area.ResultsThe main arterial branches of this region could be well identified with each method. Statistical analysis showed that the arterial pattern was similar in all subjects. The prevalence of major arteries is low in the upper posterior area though large in proximity to the auricle region.ConclusionsDiverse methods indicate the advantages of a posterior superior incision because the major arteries and nerves are at less risk of damage and best preserved. Although injury to these structures is rare, when it occurs, the distal flow is compromised and the peri-implant area is left intact. Hand-held Doppler is efficient and cost-effective in finding the best position for incision, if necessary, in subjects with a history of surgical stress to the retroauricular skin.Trial registrationThis was a non-interventional study.

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The temporoparietal fascial flap in head and neck reconstruction: The workhorse from above

Cited by 3 publications

References 6 publications

Chimeric superficial temporal artery based skin and temporal fascia flap plus temporalis muscle flap - An alternative to free flap for suprastructure maxillectomy with external skin defect

Chimeric superficial temporal artery based skin and temporal fascia flap plus temporalis muscle flap - An alternative to free flap for suprastructure maxillectomy with external skin defect

Pedicled temporoparietal fascial flap for combined revascularization in adult moyamoya disease

Vascular mapping of the retroauricular skin – proposal for a posterior superior surgical incision for transcutaneous bone-conduction hearing implants

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