Temporal Flap Variations for Craniofacial Reconstruction

Abstract

Learning Objectives: After studying this article, the participant should be able to: 1. Describe the anatomy of the temporal region. 2. Identify the types and possible indications of the temple group flaps to be selected depending on the defects, and then raise the flap safely for reconstruction. 3. Predict and manage successfully the potential complications of surgery. Background: Good harmony of color and texture with surrounding tissues, thinness and adequate pliability, good alignment, obliteration of the cavities, and minimal donor-site morbidity are the main features of an ideal flap to be used in the reconstruction of craniofacial defects. Despite the numerous local, regional, and free flaps that have been described, to date, there has not yet been an ideal flap. The authors discuss the reconstruction alternatives presented by the temporal site and its outcomes. Methods: The temporal group flaps can be raised using one or more tissues based on the superficial temporal artery and its branches, depending on the defect site and nature. They can be designed as axial skin flaps consisting of transposition or V-Y island flaps, composite flaps including more than one tissue, and chimeric flaps involving both the temple skin and temporal fascia based on the two distal branches of the superficial temporal artery. Results: The temporal region is a good donor site for closure of craniofacial defects, by means of its rich vascular network and almost all types of tissue, including skin, fascia, muscle, galea, calvarial bone, and periosteum. The charm of this region has gradually increased as clinical experiences have advanced and its anatomy has been better understood. Conclusions: The authors discuss the history, anatomy, surgical dissection techniques, and potential complications and their management of temporal flaps. (Plast. Reconstr. Surg. 119: 152e, 2007.)