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Venous Congestion in Pedicled Frontal Branch Superficial Temporal Artery Flaps Reconstructions for Head and Neck Defects

A Review

Loh, Charles Yuen Yung, MBBS, MSc, MS, MRCS*†; Shanmugakrishnan, R. Raja, MBBS, MRCS, DNB*; Nizamoglu, Metin, MBBS, MRCS*; Tan, Alethea, MBBS, MRCS*; Duarte, Marco, BMBS, MRCS*; Khan, Waseem Ullah, MBBS, LLM, MRCS, FRCS(Plast)*; El-Muttardi, Naguib, MD, FRCS(Plast)*

doi: 10.1097/SAP.0000000000001602
Review Paper

The superficial temporal artery (STA) flap is a versatile flap for head and neck defect reconstruction. It can be based on the frontal branch of the STA and an islanded 360-degree rotation arc for various defects on the scalp, cheek, and auricular region. It provides a nonmicrosurgical option for reconstructing such defects, which is itself relatively easy to perform. However, venous congestion is a problem than often can cause worry to the clinician and hence preclude its use. In this review, we revisit this flap in head and neck reconstruction, with case examples used for reconstruction of defects on the scalp, maxilla, lip, ear, and retroauricular area. The STA flap in our review can be used either as a fasciocutaneous flap or with its fascia alone. The main issue with the STA flap is that it is generally a high-inflow flap with variable outflow. Venous congestion is frequently encountered in our practice, and adequate management of the venous drainage in the postoperative period is crucial in ensuring its success as a versatile and viable option for head and neck reconstruction.

From the *St Andrew's Centre for Plastic and Reconstructive Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, United Kingdom; and

Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Received April 29, 2018, and accepted for publication, after revision July 3, 2018.

Conflicts of interest and sources of funding: None of the authors have a financial interest in any of the products, devices, or drugs mentioned in this article.

Reprints: Naguib El-Muttardi, MD, FRCS(Plast), St Andrew's Centre for Plastic and Reconstructive Surgery, Broomfield Hospital, Court Rd, Chelmsford, Essex CM1 7ET, United Kingdom. E-mail:

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