A Comparative Study on Superior Auricular Artery Island Flaps With Various Pedicles for Repair of Periorbital Defects

Abstract

Superior auricular artery (SAA) island flaps elevated from the retroauricular region have perfect color, thickness, and texture match with facial skin. In this article, reconstruction of periorbital defects with SAA island flaps is presented. Flaps were categorized into three types because they were elevated on three different pedicles. A type 1 flap was a superficial temporal vessel pedicled SAA island flap with antegrade blood flow. A type 2 flap was a reverse flow SAA island flap based on the frontal branch of the superficial temporal artery (STA). A type 3 flap was a reverse flow SAA island flap based on the parietal branch of STA. Fourteen patients (9 females and 5 males) aged between 31 years and 74 years were treated with these flaps. Two patients with lower eyelid, two patients with upper eyelid, three patients with malar, two patients with infraorbital, one patient with lateral canthal upper eyelid, and four patients with forehead defects underwent surgical intervention. Sizes of the flaps varied between 3x6 cm and 8x6 cm. Venous congestion was observed in all patients in the early postoperative period and lasted for 5 to 9 (mean, 6.6) days in type 1 flap, 5 to 9 (mean, 6.7) days in type 2 flap, and 2 to 5 (mean, 3.6) days in type 3 flap. Apart from distal necrosis of 1x1 cm in one patient and superficial dermal sloughing in two patients, no complications were encountered. Aesthetically and functionally successful results with minimal donor site morbidity were obtained in all patients during the 2 to 22 (mean 10.8) month follow-up period.

Feasibility, comparability and outcomes of three acquainted facial island flaps for periorbital defects reconstruction

“…In terms of expansion of TFs, FFs and BFs, they are characterised by stable blood supply and tissue availability. Direct suture is conducted for the closure of the island flaps donor site in our study, neither required split‐thickness skin grafting nor other local or regional flaps 11,13,15 …”

Total and near‐total lower eyelid reconstruction with prefabricated orbicularis oculi musculocutaneous island flap

“…However, larger defects require flap closure 2 . Local flaps from various sites like nasolabial, 10 retroauricular, 11 upper lid, 4,5 forehead, 12 retroangular 13 regions and many others have been reported to be used for reconstruction of lower eyelid defects. Total defects of the lower lid are successfully reconstructed with well‐known cheek rotation advancement flap with chondromucosal or chondrocutaneous grafts.…”

Free temporal artery posterior auricular skin (TAPAS) flap: A new option in facial and intra‐oral reconstruction

“…However, flaps such as the facial artery perforator, paramedian forehead, and submental flaps all leave a visible scar. Various flaps consisting of posterior auricular skin based on a pedicle containing branches of the ST artery have also been described . These pedicled versions of the TAPAS flap have the disadvantage of limited manoeuvrability in contrast to the free TAPAS flap.…”

“…A pedicled flap incorporating retroauricular skin and based on the superficial temporal (ST) vessels was first described in 1969 by Washio and since then numerous variations of the same pedicled flap have been reported …”