Superficial Temporal Artery Perforator Flap: Indications, Surgical Outcomes, and Donor Site Morbidity

Abstract

The aim of this retrospective case series was to discuss indications, surgical outcomes, and donor site morbidity in the use of superficial temporal artery perforator (STAP) flaps in intra-oral or extra-oral facial reconstruction. This study involved 9 patients treated with a STAP flap at the Maxillo-Facial Surgery Unit of the University of Campania “Luigi Vanvitelli”, Naples. A STAP flap was used alone or in combination with other local flaps, for the coverage of facial soft tissue defects, after the resection of craniofacial malignant tumors (n = 7) or as a salvage flap, in partial or total microvascular flap loss (n = 2). The STAP flap was proven to be a valuable surgical option despite it not being frequently used in facial soft tissue reconstruction nor was it chosen as the first surgical option in patients under 70 year’s old. Donor site morbidity is one of the major reasons why this flap is uncommon. Appropriate patient selection, surgical plan, and post-surgical touch-ups should be performed in order to reduce donor site scar morbidity.

Non-Surgical Touch-Up with Hyaluronic Acid Fillers Following Facial Reconstructive Surgery

“…It was demonstrated in humans that HA injections increase local vascularization and epidermal thickness contextually to collagen proliferation and dermal fibroblasts production [131,132]. Another reason for tissue flexibility improvement after local injection of HA could be due the local hydration linked to the strong hydrophilicity of HA [133,134]. Collecting water particles, HA filler increases soft tissue volume, providing greater elasticity [133].…”

“…Palatal defects, typically composite in nature, are challenging to reconstructive surgeons due to the lack of availability of local tissue to fill the gap [134,138]. Moreover, surgical repair aims to use a flap to restore function with minimal donor-site compromise.…”

“…Moreover, microvascular flaps, especially for intraoral defects, make "like-with-like" reconstruction difficult [142], and represent procedures that necessitate long surgical time, utilization of intensive care unit (ICU), amplified rates of revision surgery, prolonged hospitalization, and a considerable donor site morbidity. For example, FFF donor-site compromise is reported as a delayed graft uptake, numbness, chronic pain, aesthetic impairment, reduced pinch strength, and wrist extension [134][135][136][137][138][139][140][141][142][143][144].…”

Surgical Strategies for Eyelid Defect Reconstruction: A Review on Principles and Techniques

“…Thus, they are more suitable for the reconstruction of large eyelid defects. However, these techniques require superb surgical skills for dissecting the perforators to avoid flap congestion and subsequent sequelae at the donor site [ 35 , 36 ].…”

Health-Related Quality of Life in Oral Cancer Patients: Scoping Review and Critical Appraisal of Investigated Determinants

“…Reconstruction strategies are mainly chosen according to the defect size and composition: small to moderate simple defects may benefit from reduced donor site morbidity by performing local flaps, while large and/or composite defects need free or regional flaps to be restored [75,86]. Therefore, the evaluation of the reconstruction as an HRQOL determinant should consider some baseline confounding variables, such as the cancer stage, the extent of resection, the mandibular involvement, and the adjuvant therapies.…”