Application Of Superficial Temporal Artery Flap In Repairing The Wound In The Craniofacial Region: A Retrospective Analysis In One Center

Part One:Application of superficial temporal artery flap in repairing the wound after the resection of craniofacial malignant tumors Objective: Craniofacial malignant tumors requires not only extended resection but also appropriate reconstruction to restore appearance.Here we introduced the application of superficial temporal artery(STA)flap in wound repairing after the resection of craniofacial malignant tumors.Methods: From Jan.2015 to Dec.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.Part Two:Repair of defects in the scalp and face with expanded superficial temporal artery flaps Objective: Defects resulted from the removal of large scars,benign tumors,severe pigmentation abnormalities,and vascular malformations,etc.,in the scalp and face need to be repaired to restore the appearance.Here we introduced the application of various expanded superficial temporal artery(STA)flaps in the repair of above defects.Methods: From Jan.2015 to Feb.2019,20 patients with craniofacial secondary defects received the repair with expanded STA flaps in our clinic.The defects were resulted from the removal of scalp scar(n=7),neurofibroma(n=4),sebaceous nevus(n=3),arteriovenous malformation(n=2),facial scar(n=3),and port-wine stain(n=1).The expanded STA flaps included 14 cases of flaps pedicled by parietal branch of STA,2 cases of flaps pedicled by parietal branch of STA combined with laser hair removal,2case of flaps pedicled by frontal branch of STA,and 2 cases of prefabricated expanded skin flap with the superficial temporal fascia in the neck.Results: The two-stage operation and water-filling expansion were accomplished in all patients.All flaps survived well,except one flap with venous congestion,which resolved after blood-letting and application of drugs promoting venous draining.In the three to six months follow-up,the flaps’ color,texture,and thickness were satisfying.Conclusions: Individual application of different types of expanded STA flaps could achieve ideal results in repairing craniofacial secondary defects.