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J Neurol Surg A Cent Eur Neurosurg 2022; 83(02): 173-182
DOI: 10.1055/s-0041-1739213
Review Article

Temporal Flaps in Head and Neck Reconstructive Surgery: A Systematic Review of Surgical Techniques

Filippo Gagliardi
1   Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
,
Silvia Snider
1   Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
,
Edoardo Pompeo 
1   Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
,
Marzia Medone
1   Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
,
Martina Piloni
1   Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
,
Leone Giordano
2   Department of Otorhinolaryngology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
,
Pierfrancesco De Domenico
1   Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
,
Francesca Roncelli
1   Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
,
Pietro Mortini
1   Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
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Abstract

The temporal region is a great source of vascularized flap, providing extremely variable and versatile options for reconstruction in head and neck surgery. Its popularity has led to the conception of a large variety of different flaps, in terms of contents and design. Temporal flaps are highly pliable and flexible, providing adequate bulk to obliterate dead spaces and improving engraftment, thus facilitating wound healing. The need to access different anatomical compartments, often far from the original flap anatomical site, has led surgeons to develop techniques to enlarge pedicles and bulk, by reverting and splitting flaps' contents, as well as through partial mandibular and zygomatic resection. To further increase versatility, a multilayered combination of different regional tissues and muscle segmentation techniques has been described. Historically, each flap has had its own proponents and opponents, but a pointy review systematizing techniques and comparatively analyzing different flaps was still missing in the literature. The field of use of some flaps has been progressively limited by the increasing relevance of free tissue transfers, which nowadays may provide success rates up to 95% with a constrained morbidity, thus offering an effective alternative, when available. Given the wide range of reconstructive strategies based on temporal flaps, there is still a great debate on nomenclature and surgical techniques. The present study systematizes the topic, classifying regional flaps according to contents and indications. Harvesting techniques are described stepwise and schematically illustrated, thus offering an indispensable tool to the armamentarium of reconstructive surgeons.

Keywords

temporal flap - skull base reconstruction - myofascial flap - galeopericranial flap - chimeric flap - reverse flap - head and neck reconstruction

Disclosure

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


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Neither the paper nor any part of its essential substance has been published or submitted for publication in other medical journals.




Publication History

Received: 13 February 2021

Accepted: 23 June 2021

Article published online:
12 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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