Advertisement
Review| Volume 65, ISSUE 2, P141-148, February 2012

The versatility of the temporoparietal fascia flap in head and neck reconstruction

      Summary

      Objectives

      The temporoparietal fascia flap (TPFF) is a versatile tool in head and neck reconstruction. This article aims to describe the spectrum of TPFF applications through a series of case studies and related review of the literature.

      Methods

      Medical records were reviewed to identify cases that represent major TPFF application categories. A literature review was performed to support the presentation and discussion of each case category.

      Results

      Seven cases were identified each representing a distinct application category. These included auricular reconstruction, hair-bearing tissue transfer, facial soft tissue augmentation, cutaneous and mucosal oncologic defect repair, reconstruction after salvage laryngectomy, skull base reconstruction, and orbital reconstruction.

      Conclusion

      The TPFF is a uniquely versatile tool in head and neck reconstructive surgery. Outstanding in its pliable, ultra-thin yet hardy and highly vascular form, the temporoparietal fascia flap is a workhorse for the creative head and neck reconstructive surgeon.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Abul-Hassan H.S.
        • von Drasek Ascher G.
        • Acland R.D.
        Surgical anatomy and blood supply of the layers of the temporal region.
        Plast Reconstr Surg. 1986; 77: 17-28
        • Standring S.
        Grey’s anatomy: The anatomical basis of clinical practice. 39th ed. Elsevier Churchill Livingstone, Edinburgh, Sccotland2008
        • Tellioğlu A.T.
        • Tekdemir I.
        • Erdemli E.A.
        Temporoparietal fascia: An anatomic and histologic reinvestigation with new potential clinical applications.
        Plast Reconstr Surg. 2000; 105: 40-45
        • Babakurban S.T.
        • Cakmk O.
        • Kendir S.
        Temporal branch of the facial nerve and its relationship to fascial layers.
        Arch Facial Plast Surg. 2010; 12: 16-23
        • Beheiry E.E.
        • Abdel-Hamid F.A.
        An anatomical study of the temporal fascia and related temporal pads of fat.
        Plast Reconstr Surg. 2007; 119: 136-144
        • Park C.
        • Lew D.H.
        • Yo W.M.
        An analysis of 123 temporoparietal fascial flaps: Anatomic and clinical considerations in total auricular reconstruction.
        Plast Reconstr Surg. 1999; 104: 1295-1306
        • Pinar Y.A.
        • Govsa F.
        Anatomy of the superficial temporal artery and its branches: Its importance for surgery.
        Surg Radiol Anat. 2006; 28: 248-253
        • Pitanguy I.
        • Ramos A.S.
        The frontal branch of the facial nerve: The importance of its variations in face lifting.
        Plast Reconstr Surg. 1966; 352: 352-356
        • Gosain A.K.
        • Sewall S.R.
        • Yousif N.J.
        The tempoaral branch of the facial nerve: How reliably can we predict its path?.
        Plast Reconstr Surg. 1997; 99: 1224-1226
        • Lei T.
        • Gao J.H.
        • Xu D.C.
        • et al.
        Using the frontal branch of the superficial temporal artery as a landmark for locating the course of the temporal branch of the facial nerve during rhytidectomy: An anatomical study.
        Plast Reconstr Surg. 2005; 116: 623-629
        • Kim J.C.
        • Hadlock T.
        • Vavares M.A.
        Hair-bearing temporoparietal fascial flap reconstruction of upper lip and scalp defects.
        Arch Facial Plast Surg. 2001; 3: 170-177
        • Lai A.
        • Cheney M.L.
        Temporoparietal fascial flap in inorbital reconstruction.
        Arch Facial Plast Surg. 2000; 2: 196-201
        • Terzis J.K.
        • Olivares F.S.
        Uses of superficial temporalis fascial flap in facial paralysis.
        Plast Reconstr Surg. 2008; 122: 176e-185e
        • Helling E.R.
        • Okoro S.
        • Kim G.
        Endoscope-assisted temporoparietal fascia harvest for auricular reconstruction.
        Plast Reconstr Surg. 2008; 121: 1598-1605
        • Yano H.
        • Fukui M.
        • Yamada K.
        Endoscopic harvest of free temporoprietal fascial flap to improve donor-site morbidity.
        Plast Reconstr Surg. 2001; 107: 1003-1009
        • Brent B.
        • Byrd H.S.
        Secondary ear reconstruction with cartilage grafts covered by axial, random and free flaps of temporoparietal fascia.
        Plast Reconstr Surg. 1983; 72: 141-151
        • Mladick R.A.
        • Horton C.E.
        • Adamson J.E.
        The pocket principle: A new technique for the reattachment of a severed ear part.
        Plast Reconstr Surg. 1971; 48: 219-223
        • Pennington D.G.
        • Lai M.F.
        • Pelly A.D.
        Successful replantation of a completely avulsed ear by microvascular anastomosis.
        Plast Reconstr Surg. 1980; 65: 820-823
        • Steffen A.
        • Katzbach R.
        • Klaiber S.
        A comparison of ear reattachment methods: A review of 25 years since Pennington.
        Plast Reconstr Surg. 2006; 118: 1358-1364
        • Anous M.M.
        • Hallock G.G.
        Immediate reconstruction of the auricle using amputated cartilage and the temporoparietal fascia.
        Ann Plast Surg. 1988; 21: 378-381
        • Saad Ibrihim S.M.
        • Zidan A.
        • Madani S.
        Totally avulsed ear: New technique of immediate ear reconstruction.
        J Plast Reconstr Aesthet Surg. 2009; 62: 846
        • Park C.
        • Mun H.Y.
        Use of an expanded temporoparietal fascial flap technique for total auricular reconstruction.
        Plast Reconstr Surg. 2006; 118: 374-382
        • Reinisch J.F.
        • Lewin S.
        Ear reconstruction using a porous polyethylene framework and temporoparietal fascia flap.
        Facial Plast Surg. 2009; 25: 181-189
        • Yang S.L.
        • Zheng J.H.
        • Ding Z.
        Combined Fascial flap and expanded skin flap for enveloping Medpo framework in microtia reconstruction.
        Aesthetic Plast Surg. 2009; 33: 518-522
        • McCarn K.E.
        • Park S.S.
        Lip reconstruction.
        Otolaryngol Clin North Am. 2007; 40: 361-380
        • Matsuba H.M.
        • Hakki A.R.
        • Romm S.
        Variations on the temporoparietal fascial flap.
        Laryngoscope. 1990; 100: 1236-1240
        • Motomura H.
        • Muraoka M.
        • Nose K.
        Eyebrow reconstruction with intermediate hair from the hairline of the forehead on the pedicled temporoparietal fascial flap.
        Ann Plast Surg. 2003; 51: 314-318
        • Zhang Y.
        • Jin R.
        • Sun B.
        Pedicaled superfcial temporal fascia sandwich flap for reconstruction of severe facial depression.
        J Craniofac Surg. 2009; 20: 505-508
        • Guven E.
        • Kuvat S.V.
        • Aydin H.U.
        Facial contour reconstruction with temporoparietal prelaminated dermal-adipose flaps.
        J Craniomaxillofac Surg. 2009 Nov; 20 ([Epub ahead of print])
        • Nayak V.K.
        • Deschler D.G.
        Pedicled temporoparietal fascial flap reconstruction of select intraoral defects.
        Laryngoscope. 2004; 114: 1545-1548
        • Pinto F.R.
        • de Magalhaes R.P.
        • Capelli Fde A.
        Pedicled temporoparietal galeal flap for reconstruction of intraoral defects.
        Ann Otol Rhinol Laryngol. 2008; 117: 581-586
        • Beeby M.P.
        • Artigot J.L.
        • Zuloaga A.A.
        Vascularized temporoparietal fascial flap for closure of an orocutaneous fistula.
        Br J Plast Surg. 2001; 54: 275-276
        • Teknos T.N.
        • Myers L.L.
        • Bradford C.R.
        Free tissue reconstruction of the hypopharynx after organ preservation therapy: Analysis of wound complications.
        Laryngoscope. 2001; 111: 1192-1196
        • Fung K.
        • Teknos T.N.
        • Vandenberg C.D.
        Prevention of wound complications following salvage laryngectomy using free vascularized tissue.
        Head Neck. 2007; 29: 425-430
        • Sardesai M.G.
        • Fung K.
        • Yoo J.H.
        Donor-site morbidity following radial forearm free tissue transfer in head and neck surgery.
        J Otolaryngol Head Neck Surg. 2008; 37: 411-416
        • Militsakh O.N.
        • Werle A.
        • Mohyuddin N.
        Comparison of radial forearm with fibula and scapula osteocutaneous free flaps for oromandibular reconstruction.
        Arch Otolaryngol Head Neck Surg. 2005; 131: 571-575
        • Gil Z.
        • Gupta A.
        • Kummer B.
        The role of pectoralis flap in salvage laryngectomy.
        Arch Otolaryngol Head Neck Surg. 2009; 135: 1019-1023
        • Moukarbel R.V.
        • Fung K.
        • Franklin J.H.
        • et al.
        Neck and shoulder disability following reconstruction with pectoralis major pedicled flap.
        Laryngoscope. 2010; 120: 1129-1134
        • Fortes F.S.
        • Carrau R.L.
        • Snyderman C.H.
        Transpterygoid transposition of a temporoparietal fascial flap: A new method for skull base reconstruction after endoscopic expanded endonasal approaches.
        Laryngoscope. 2007; 117: 970-976
        • Taha M.
        • Carroll T.
        Vascularized temporoparietal fascial flap for the treatment of a traumatic cerebrospinal fluid fistual in the middle cranial fossa.
        J Neurosurg. 2009; 111: 393-395
        • Hadad G.
        • Bassagastegy L.
        • Carrau R.L.
        • et al.
        A novel reconstructive technique after endoscopic expanded endonasal approaches: Vascular pedicle nasoseptal flap.
        Laryngoscope. 2006; 116: 1882-1886
        • Snyderman C.H.
        • Janecka I.P.
        • Sekhar L.N.
        Anterior cranial base reconstruction: Role of galeal and pericranial flaps.
        Laryngoscope. 1990; 100: 607-614
        • Johns M.E.
        • Winn H.R.
        • McLean W.C.
        Pericranial flap for the closure of defects of craniofacial resection.
        Laryngoscope. 1981; 91: 952-959
        • Chiu E.S.
        • Kraus D.
        • Bui D.T.
        Anterior and middle cranial fossa skull base reconstruction using microvascular free tissue techniques: Surgical complications and functional outcomes.
        Ann Plast Surg. 2008; 60: 514-520
        • Weber S.M.
        • Kim J.H.
        • Wax M.K.
        Role of free tissue transfer in skull base reconstruction.
        Otolaryngol Head Neck Surg. 2007; 136: 914-919
        • Hanasono M.M.
        • Lee J.C.
        • Tang J.S.
        An algorithmic approach to reconstructive surgery and prosthetic rehabilitation after orbital exenteration.
        Plast Reconstr Surg. 2009; 123: 98-105
        • Davison S.P.
        • Mesbahi A.N.
        • Clemens M.W.
        Vascularized calvarial bone flaps and midface reconstruction.
        Plast Reconstr Surg. 2008; 122: 10e-18e
        • Parhiscar A.
        • Har-El G.
        • Turk J.B.
        Temporoparietal osteofascial flap for head and neck reconstruction.
        J Oral Maxillofac Surg. 2002; 60: 619-622