Skip Navigation LinksHome > September 2010 - Volume 126 - Issue 3 > The Temporoparietal Fascial Flap Is an Alternative to Free F...
Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e3181e3b6f0
Reconstructive: Head and Neck: Original Articles

The Temporoparietal Fascial Flap Is an Alternative to Free Flaps for Orbitomaxillary Reconstruction

Kim, John Y. S. M.D.; Buck, Donald W. II M.D.; Johnson, Sarah A. B.S.; Butler, Charles E. M.D.

Collapse Box

Abstract

Background: The temporoparietal fascial flap is a thin, pliable, well-vascularized, locoregional flap that can be a reasonable alternative to traditional free flap reconstruction, but its utility for reconstruction of orbitomaxillary defects is often overlooked. The authors investigated the rationale for and benefits of the use of this flap over free tissue transfer in a well-defined subset of head and neck cancer cases.

Methods: The records of all patients who underwent temporoparietal fascial reconstruction for orbitomaxillectomy between 1993 and 2008 were reviewed. Demographic data, preoperative plans, operative details, and outcomes were assessed to (1) determine the overall outcomes for the temporoparietal fascial flap and (2) analyze preoperative and intraoperative factors that led to the choice of this flap instead of the originally planned free flap.

Results: Nineteen patients (mean age, 56 years) were included in this study. Ten (53 percent) were initially considered for free flap reconstruction. Among them, the principal reasons for electing the temporoparietal fascial flap were (1) smaller-than-anticipated extent of resection, (2) need for coverage of implant or bone or thin prosthesis support, and (3) patient comorbidities. Nine resections (47 percent) involved the orbit alone, two (11 percent) involved the maxilla alone, and eight (42 percent) involved a combination of the two. Five patients (26 percent) received neoadjuvant radiation. Four (21 percent) experienced complications (flap failure, ectropion, enophthalmos with intraoral mesh extrusion, and partial skin graft loss). Mean follow-up time was 36 ± 27 months.

Conclusion: The temporoparietal fascial flap is a viable alternative to free flaps for orbitomaxillary defects when orbital resection is limited, when obturator reconstruction is desired, or when comorbidities preclude microvascular surgery.

©2010American Society of Plastic Surgeons

Login

Article Tools

Share


The Clinical Masters of PRS – Breast eBooks
4 Essential eBooks for Plastic Surgeons