Upper lip reconstruction using a pedicel superficial temporal artery flap

Superficial Temporal Artery Posterior Branch Flap for Reconstruction of Composite Oral/Perioral Defects

PURPOSE

Defects involving total lower and/or upper lip often extend to intraoral and/or perioral areas. Flaps based on superficial temporal artery, either as pedicled or free flaps, can be used for reconstruction of various head and neck defects. In this clinical study, we tried to demonstrate the application of a pedicled flap based on the posterior branch of superficial temporal artery in 3-dimensional reconstruction of these composite oral/perioral defects as a successful alternative in cases where microvascular tissue transfer cannot be performed.

PATIENTS AND METHODS

Six male patients with composite perioral/oral defects who underwent reconstruction with a pedicled flap based on the posterior branch of the superficial temporal artery between April 2020 and December 2020 were evaluated retrospectively. Demographic data, topographic data of defects, and the dimensions of the flaps were gathered from patient files. All patients required reconstruction after tumor resection.

RESULTS

All flaps survived without any signs of partial or total necrosis. Postoperatively, the patients did not report any oral incompetence or drooling, and they were able to fully close their mouths.

CONCLUSIONS

Pedicled flaps based on the posterior branch of superficial temporal artery provide reliable results in composite perioral/oral reconstruction.

One Pedicled Superficial Temporal Artery Hair-bearing Flap to Reconstruct Three Different Anatomical Areas of the Burnt Face: A Personal Technique

ABSTRACT

Reconstruction of the burnt face is a challenge. In men, the best option to hide facial scars and get rid of the grafted facial appearance is to use the superficial temporal artery hair-bearing flap. In the literature, the superficial temporal artery flap hair-bearing flap has been used to reconstruct one facial anatomical area in men such the eyebrows, the beard, or the mustache area. In this communication, the author describes a personal technique that allows the use of one pedicled superficial temporal artery hair-bearing flap to reconstruct both eyebrows and improve the grafted appearance of the upper/lower lips post the release and graft of burn contractures. The technique will be demonstrated by a case presentation.

Reconstruction of severe burn contractures of the upper lip in males using a pedicled superficial temporal artery hair-bearing flap. Two case reports

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The use of the superficial temporal artery free flap has been described for upper lip burn contractures.

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However, the pedicled superficial temporal artery flap is much simpler to execute than free flaps.

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The main concern with the use of the pedicled superficial temporal artery flap in these cases is regarding the viability of the distal end of the flap.

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We demonstrate this in two case reports.

Introduction

Severe burn contractures of the upper lip are usually treated either with full thickness skin grafts or flaps. Most authors recommend the free radial forearm flap as the flap of choice. In males, another free flap option is the use of the superficial temporal artery hair-bearing free flap.

Case reports

In this report, we demonstrate that the superficial temporal artery hair-bearing flap may be used as a pedicle flap (rather than a free flap) for the reconstruction of severe upper lip burn contractures in males. We show our method of flap delay and design to ensure that the distal part of the flap will survive; and this will be demonstrated in two case reports.

Discussion

The pedicled superficial temporal artery flap is much simpler to execute than free flaps.

Conclusions

Severe post burn contractures of the upper lip in males may be reconstructed using the pedicled superficial temporal artery hair-bearing flap. In order for the flap to reach the contralateral side of the lip, it will have to cross the midline in the scalp. We demonstrate our method of flap delay and design to ensure flap safety and viability. We also show that concurrent burn deformities in close proximity of the upper lip should be treated prior to upper lip reconstruction. Finally, we stress on the principle of reconstructing the entire skin of the upper lip as one aesthetic unit.

Application of Superficial Temporal Artery Flap in Wound Repairing After the Resection of Craniofacial Malignant Tumors

BACKGROUND AND OBJECTIVE

Craniofacial malignant tumors require not only extended resection but also appropriate reconstruction to restore appearance, which remains a major challenge. Here the authors introduced the application of superficial temporal artery (STA) flap in wound repairing after the resection of craniofacial malignant tumors.

METHODS

From January 2015 to December 2018, 16 patients with craniofacial malignant tumors were enrolled into the study, including squamous cell carcinoma (n = 6), basal cell carcinoma (n = 3), melanoma (n = 4), neuroendocrine carcinoma (n = 2), and dermatofibrosarcoma protuberance (n = 1). All of the tumors underwent extended resection. The defects formed were repaired by flaps pedicled with superior or frontal branch of STA. Donor sites were repaired with skin grafts. Patients were followed up for 6 months to 3 years to monitor the recurrence of tumor.

RESULTS

All the flaps survived well. Venous congestion occurred in two cases but resolved after blood-letting and application of drugs promoting venous draining. During the follow-up, no recurrence of tumors was observed and the appearance of flaps was satisfying. But flap donor sites suffered from relatively poor appearance or alopecia deformity.

CONCLUSIONS

The STA flap is reliable for wound repairing after resection of craniofacial malignant tumors. The STA parietal branch flap is preferred for repairing scalp defects, while the STA frontal branch flap is preferred for repairing facial defects. However, the STA flap should be used prudently due to its disadvantage of the deformity in scalp donor sites.

Aesthetic considerations in flap reconstruction of the burnt face in males: A demonstrative case report

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A man presented with a deep burn of the right side of the face.

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Reconstruction was initially done with a latissimus dorsi free flap.

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The aesthetic outcome was poor.

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Salvage was done using a superficial temporal artery flap.

Introduction

The face is unique because functional and aesthetic considerations are equally important. Extensive deep chemical burns of the face are usually reconstructed with flaps. In males, the use of the hair – bearing superficial temporal artery flap has the advantage of achieving a satisfactory outcome with regards to both function and aesthetics.

Presentation of case

A 49-year-old man sustained a deep chemical burn to the right side of the face and neck. The resulting right peri-oral and neck contractures were initially reconstructed with a latissimus dorsi myo-cutaneous free flap. The functional outcome was satisfactory. The cosmetic outcome was poor and caused the patient to go into depression. Salvage was done using a hair-bearing superficial temporal artery flap.

Discussion

In males, the use of the hair-bearing superficial temporal artery flap in facial reconstruction respects the aesthetic units and is also able to achieve a satisfactory functional outcome.

Conclusion

We stress that aesthetic and functional considerations are equally important in facial reconstruction. In males, the hair-bearing superficial temporal artery flap is the flap of choice if the beard/moustache areas are involved.