Clinical Study On The Reconstruction Of The Horn Of The Scalp Island Flap With The Apical Branch Of The Superficial Temporal Artery

[Objective]The sideburn is a valuable aesthetic unit on the lateral facial region,which once injured would influence the appearance of the profile and harm patient’s mental health.This research aimed to explore the feasibility and clinical outcomes of sideburn reconstruction using the expanded island scalp flap based on the parietal branch of the superficial temporal vessel.[Methods]Between February 2012 and April 2015,7 patients underwent reconstruction of defects around the sideburn using the expanded island scalp flap.There were 3 males and 4 females with an average age of 15(range,4-44).The etiologies included burn injury in 3 patients,trauma in 1,radiation therapy in 1,and excision of congenital nevus in the remaining 2 patients.The operation was a 2-stage procedure.Before the surgery,the locations of the superficial temporal artery(STA)and its parietal and frontal branches were explored using an ultrasound Doppler probe and outlined on the skin.In the first-stage surgery,according to the sideburn defect,a tissue expander of the appropriate size was inserted beneath the superficial temporal fascia which containing the parietal branch of the superficial temporal vessel.Two weeks after the surgery,saline injection was commenced at a weekly interval until the expander was adequately inflated.In the second-stage surgery,the lesion was excised and the tissue expander removed.The expanded island scalp flap based on the parietal branch of the superficial temporal vessel was raised and advanced towards the defect of the sideburn according to the contralateral normal one,while the donor site was closed primarily.[Results]All of the seven flaps were based on the parietal branch of the superficial temporal vessel.The flap size ranged from 8cm×3cm to 17cm×11cm(mean,9.71cm×5.57cm).All flaps survived and the donor sites were closed primarily without any complications.In one patient,temporofrontal hairline of the new sideburns exceeding the scope of the normal contralateral,was modified by laser hair removal subsequently.In another patient,an island frontal flap based on the frontal branch of the superficial temporal vessel was elevated simultaneously to repair the facial defect anterior to the reconstructed sideburn.Venous congestion and subsequent epidermal necrosis occurred in the distal portion of the frontal flap.The wound healed spontaneously with secondary intention.All patients were satisfied with the new aesthetic sideburn.[Conclusion]The expanded island scalp flap based on the parietal branch of the superficial temporal vessel provides a credible option for the sideburn reconstruction,which presents with natural growth,orientation of the hair,sufficient hair density,and rich blood supply as well as minimum morbidities.