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Plast Reconstr Surg Glob Open 2019 Feb 8;7(2):e2067. Epub 2019 Feb 8.

Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

The 3 most common problems after a parotidectomy are cheek contour deformity, Frey syndrome (gustatory sweating), and a visible scar on the neck. These problems can potentially be prevented by (1) facelift type incisions, which eliminate the neck incision and (2) interposition of temporoparietal fascia at the parotidectomy site that fills the defect and provides a barrier to aberrant neuronal regeneration. We followed 11 patients who underwent parotidectomy (9 superficial and 2 total parotidectomies) for a variety of parotid tumors between December 2001 and January 2018. Read More

Semin Plast Surg 2019 Feb 8;33(1):17-23. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

With the advent of the Industrial Revolution, traumatic injuries of the upper extremity increased exponentially. As a result, surgeons began to reevaluate amputation as the standard of care. Following the Second World War, local and regional pedicled flaps became common forms of traumatic upper extremity reconstruction. Read More

World Neurosurg 2019 Feb 26. Epub 2019 Feb 26.

Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

J Stomatol Oral Maxillofac Surg 2019 Feb 11. Epub 2019 Feb 11.

Division of Oral and Maxillofacial Surgery, Army Dental Centre (Research and Referral), New Delhi, India.

Reconstruction of midface defects are extremely challenging owing to the lack of suitable vascularized local flaps. The temporoparietal fascia and temporalis muscle flaps make excellent choices for midface and orbito-maxillary reconstruction. The muscle provides adequate thickness while the fascia yields pliable soft tissues for lining the midface. Read More

Plast Reconstr Surg 2019 Mar;143(3):592e-601e

Los Angeles, Calif.; and Utrecht, The Netherlands From the Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California; Cedars Sinai Hospital; and the Department of Pediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht.

Background: The temporoparietal fascia flap is frequently used in ear reconstruction. When the temporoparietal fascia flap is unavailable, options for primary or secondary salvage reconstruction are limited. In these patients, an inferiorly based occipital artery fascia transpositional flap is a good alternative for soft-tissue coverage over a framework. Read More

J Plast Reconstr Aesthet Surg 2019 Jan 28;72(1):114-118. Epub 2018 Sep 28.

Lenox Hill Radiology, 61 East 77th Street, Ofc 1, New York, NY 10075, United States.

Background: This retrospective study evaluated the anatomical distribution of the superficial temporal artery (STA) in supply of the temporoparietal fascial (TPF) flap for use in patients with unilateral microtia undergoing reconstruction. We aimed to determine whether embryologic arrest of pharyngeal arch development would lead to aberrant STA, which impedes reliable harvest of the TPF flap in patients requiring microtia repair.

Methods: CT angiograms (CTAs) and 3D reconstruction of the face and neck of 41 patients with microtia, aged 6-21 years, were examined. Read More

J Neurosurg 2018 Nov 1:1-7. Epub 2018 Nov 1.

1Neurorestoration Center.

Moyamoya disease (MMD) is a progressive, idiopathic cerebrovascular occlusive disease. Various revascularization techniques including direct, indirect, and combined microvascular bypasses have been described. This article presents a modified revascularization technique for MMD utilizing a pedicled temporoparietal fascial flap (TPFF) for combined revascularization. Read More

Plast Reconstr Surg 2018 12;142(6):1558-1570

Seoul, Republic of Korea From the Seoul Center for Developmental Ear Anomalies and the Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital.

Background: Microtia with hemifacial microsomia is difficult to treat because of skin volume deficiency. To provide further information for coverage techniques in microtia reconstruction, the authors have reviewed and analyzed patients who underwent surgery at their center.

Methods: A total 52 patients with microtia with hemifacial microsomia who underwent reconstruction between 2006 and 2016 were involved. Read More

J Wound Care 2018 Sep;27(9):564-572

Department of Burns, Plastic and Reconstructive Surgery, JN Medical College, Aligarh Muslim University, Aligarh, UP-202002, India.

Objective: To evaluate the various methods and outcomes of post-traumatic partial auricle wound reconstruction, and to review the benefit to the patient's quality of life and their psychological improvement after the operation.

Methods: The prospective study included patients who suffered from post-traumatic partial auricular wounds. The defects were repaired using various techniques including simple local cutaneous advancement flaps, tube flaps, cartilage framework using conchal and costal cartilage with local skin flap cover. Read More

Craniomaxillofac Trauma Reconstr 2018 Sep 25;11(3):238-241. Epub 2017 Aug 25.

Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York.

Nasoseptal perforations can be a challenging defect for the reconstructive surgeon, with repair limited by the surrounding tissue availability and the defect size. In patients with a history of cocaine use, often the integrity of surrounding vasculature is questionable and large defects may not be well suited for local reconstruction. In the otolaryngology literature, several reconstructive options using local tissue and synthetic materials have been described, but there have been no reports of microvascular free flaps utilized in this regard. Read More

Plast Reconstr Surg Glob Open 2018 May 2;6(5):e1741. Epub 2018 May 2.

Avicenna Tajik State Medical University, Dushanbe, Tajikistan.

Background: Auricular reconstruction is 1 of the biggest challenges of facial plastic surgery. The aim of this study was to evaluate the efficacy of 1-stage reconstruction of an auricle using a temporoparietal fascia flap (TPFF).

Methods: In this nonrandomized study, autologous auricle bodies with emergency condition and cartilaginous graft from projection of a costal arch from the VI-VII ribs were used. Read More

J Reconstr Microsurg 2018 Oct 18;34(8):590-600. Epub 2018 May 18.

Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas.

Background:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. Read More

Arch Craniofac Surg 2018 Mar 20;19(1):79-82. Epub 2018 Mar 20.

Cirurgia Plástica Transplante Capilar, Pará de Minas, Brasil.

Formation of an ideally-shaped tragus remains one of the most challenging issues during staged tragus reconstruction in microtia patients. The authors describe a new method used to treat a unique case of concha-type microtia in which the 10-year-old male patient had only a portion of pre-existing cartilage at the tragus site. An anomalous skin lump was also present. Read More

Plast Reconstr Surg 2018 02;141(2):461-470

Los Angeles, Calif. From the Keck School of Medicine, University of Southern California; and Craniofacial and Pediatric Plastic Surgery, Cedars Sinai Medical Center.

Background: The use of a porous high-density polyethylene implant for ear reconstruction is gradually gaining acceptance because it allows for a pleasing ear reconstruction in young children before they enter school. In response to this growing interest, the authors decided to write an article clarifying in detail all the steps of this challenging procedure. In this article, the authors also answer all the common questions that surgeons have when they come to observe the operation, or when they go back to their respective practices and start performing this procedure. Read More

Medicine (Baltimore) 2017 Oct;96(42):e7038

Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.

Rationale: Gustatory otorrhea can lead to cutaneous changes, recurrent infection, and social disruption. We present a case of a late, evolving sialocutaneous fistula to the external auditory canal, managed surgically after failing conservative therapies. This case is unique by late evolution, whereby the symptoms presented with significance 27 years after her operation and 19 years after mild symptoms initially arose. Read More

Semin Plast Surg 2017 Aug 9;31(3):161-172. Epub 2017 Aug 9.

Craniofacial and Pediatric Plastic Surgery, Dell Children's Medical Center, Austin, Texas.

Total ear reconstruction has been approached by several techniques involving autologous graft, prosthetic implant, and alloplastic implant options. Recent studies have shown the superiority of porous polyethylene (Medpor, Porex Surgical) reconstruction over autologous reconstruction based on improved aesthetic results, earlier age of intervention, shorter surgery times, fewer number of required procedures, and a simpler postoperative recovery process. A durable and permanent option for total ear reconstruction, like Medpor, can help alleviate the cosmetic concerns that patients with auricular deformities may be burdened with on a daily basis. Read More

Ann Thorac Surg 2017 Sep 1;104(3):1040-1046. Epub 2017 Jun 1.

Head and Neck Surgery Department, Tenon Hospital, Paris, France; Department of Medicine, Paris VI University, Paris, France.

Background: The aim of tracheal reconstruction is to provide an airtight and noncollapsible airway covered with a suitable epithelial lining. To date, no ideal treatment is available for large tracheal defects.

Methods: We report 4 patients who underwent one-stage reconstruction for a cricotracheal stenosis with a free temporoparietal fascia flap and costal cartilage grafts. Read More

J Plast Reconstr Aesthet Surg 2017 Oct 24;70(10):1457-1463. Epub 2017 May 24.

Plastic, Reconstructive and Aesthetic Surgery Department, İstanbul University Cerrahpasa Medical Faculty, İstanbul, Turkey. Electronic address:

Background: Disfigurement of the face caused by postburn scars, resected congenital nevi and vascular malformations has both functional and psychological consequences. Ideal reconstruction of the facial components requires producing not only function but also the better appearance of the face. The skin of the neck, supraclavicular or cervicothoracic regions are the most commonly used and the most likely source of skin for facial reconstruction in those techniques which prefabrications with tissue expansion are used. Read More

Am J Rhinol Allergy 2017 May;31(3):190-195

Background: Septal perforation closure is still often invasive and complex, with relatively low closure rates.

Objectives: We aimed to provide the first results of a case series of 20 patients with nasal septal perforations who underwent septal perforation repair by both an open and a minimally invasive technique by using a graft that consisted of temporoparietal fascia and a polydioxanone (PDS) plate without mucosal flaps. Between 2014 and 2016, we tested, for the first time, the feasibility of the insertion of this graft via a hemitransfixion incision at our institution. Read More

Int J Pediatr Otorhinolaryngol 2017 Mar 16;94:64-67. Epub 2017 Jan 16.

Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA. Electronic address:

The management of cochlear implant extrusion (CIE) can be challenging, particularly in the pediatric population in whom reconstructive options are limited. We describe the use of the temporoparietal fascia flap (TPFF) for this purpose due to its ease of use and limited morbidity. We present a case series of two pediatric patients who underwent explantation of their devices, followed by reimplantation with TPFF coverage. Read More

Plast Reconstr Surg 2017 Apr;139(4):935-945

Mibu and Koshigaya, Japan From the Department of Plastic and Reconstructive Surgery, Dokkyo Medical University Koshigaya Hospital.

Background: In two-stage procedures for reconstruction of microtia, an axial flap of temporoparietal fascia is widely used to cover the costal cartilage blocks placed behind the framework. Although a temporoparietal fascia flap is undoubtedly reliable, use of the flap is associated with some morbidity and comes at the expense of the option for salvage surgery.

Methods: The authors devised a simplified procedure for covering the cartilage blocks by creating a pocket in the postauricular temporoparietal fascia. Read More

Am J Otolaryngol 2017 Mar - Apr;38(2):254-256. Epub 2016 Nov 25.

Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.

Introduction: PCF is the most common major complication after salvage total laryngectomy (TL), especially for previously irradiated patients with laryngeal or hypopharyngeal cancer.

Methods/results: A 65-year-old woman presented with recurrent bilateral supraglottic SCC requiring salvage TL 5.5years after initial T1N0M0 epiglottic SCC resection. Read More

Acta Neurochir (Wien) 2016 12 7;158(12):2291-2294. Epub 2016 Oct 7.

Department of Neurosurgery, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France.

Background: Endoscopic endonasal approaches (EEA) are an alternative for removing challenging nasopharyngeal or skull base lesions. In some cases, a nasoseptal flap (NSF) is not always available and such complex procedures may lead to carotid arteries exposition and/or dura mater (DM) wide opening. Meticulous carotid coverage and DM reconstruction are crucial for preventing early and delayed complications. Read More

Plast Reconstr Surg 2016 Aug;138(2):307e-16e

Shanghai, People's Republic of China From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.

Background: Although a standard classification system and corresponding reconstruction methods are well described for microtia, establishing a classification system and corresponding surgical strategies for traumatic ear defects is difficult because the size, shape, and local skin conditions of each defect differ considerably. In this article, the authors describe a useful new classification system and corresponding surgical approaches.

Methods: Ear defects were classified into four types according to defect size and surrounding skin conditions. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2016 Feb;30(2):208-10

Objective: To investigate the application and effectiveness of split-thickness scalp graft and temporoparietal fascia flap in the low hairline auricle reconstruction in microtia patients.

Methods: Between July 2010 and April 2015, 23 patients with low hairline microtia (23 ears) underwent low hairline auricle reconstruction. There were 16 males and 7 females with the mean age of 12 years (range, 6-34 years). Read More

Ann Plast Surg 2017 Feb;78(2):178-183

From the *Bona Microtia and Aesthetic Ear Surgery Clinic; †Department of Plastic and Reconstructive Surgery, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul; and ‡Department of Plastic and Reconstructive Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, South Korea.

Background: One of the most common complications of total auricular reconstruction is delayed wound healing, which results in skin necrosis and exposure of the ear framework. Various options exist for salvage of the exposed ear framework.

Methods: From January 2009 to May 2014, 149 patients underwent total auricular reconstruction using an autogenous cartilage framework or porous polyethylene framework (Medpor; Stryker, USA). Read More

J Craniofac Surg 2016 May;27(3):552-7

*Department of Plastic and Reconstructive Surgery †Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo ‡Department of Neurosurgery §Department of Head and Neck Surgery, Kameda Medical Center, Chiba, Japan.

Background: For a safe and reliable middle skull base reconstruction, the temporalis muscle flaps or pericranial-temporalis muscle flaps have usually been used as the first-choice in clinical practice. But these flaps have an inevitable disadvantage, namely, temporal hollowing. To address this problem, in this study, the authors describe the feasibility and advantages of using a muscle-sparing laterally based pericranial flap. Read More

Int J Oral Maxillofac Surg 2016 Aug 8;45(8):1023-6. Epub 2016 Apr 8.

Department of Oral and Maxillofacial Surgery, Boston Medical Center and Boston University School of Dental Medicine, Boston, MA, USA. Electronic address:

Spontaneous herniation of the condylar head into the external auditory canal (EAC) through the foramen of Huschke is extremely rare, with approximately 30 cases reported in the international literature. The typical presentation is a constellation of non-specific symptoms including otalgia, temporomandibular joint (TMJ) pain, malocclusion, otorrhea, tinnitus while chewing, and hearing loss. Clinical examination may reveal pain, granulation tissue in the EAC, or the exposed mandibular condyle with the mouth closed. Read More

Acta Neurochir (Wien) 2016 06 29;158(6):1221-4. Epub 2016 Mar 29.

Department of Plastic surgery, AP-HM Hôpital Nord Chemin des bourrely, Marseille, 13915, France.

Background: Skull base and posterior fossa surgeries are sometimes complicated by cerebrospinal fluid (CSF) fistulae, which may be challenging to treat. They can lead to meningitis, increasing global morbidity and mortality. In case of failed medical treatment, revision surgery may be required. Read More

Otol Neurotol 2016 Mar;37(3):248-51

Department of Otolaryngology, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, U.K.

Objective: To find out if the use of the vascularized temporo-parietal fascial flap (TPFF) reduces postoperative infection or wound breakdown in subtotal petrosectomy for chronic discharging ears.

Patients: A retrospective review on 26 subtotal petrosectomies with blind pit closures on chronic discharging ears performed by a single surgeon between 2000 and 2015 was performed. All patients had a minimum follow-up period of 6 months. Read More

Int J Oral Maxillofac Surg 2016 Jun 29;45(6):731-4. Epub 2015 Dec 29.

Department of Plastic and Reconstructive Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.

Treacher Collins syndrome (TCS) is a rare genetic disorder leading to congenital craniofacial malformations. Although this syndrome presents with various symptoms, corrective surgery for bilateral microtia with low hairline is one of the most challenging operations given the complex contours of the external ear. In this technical note, a novel, simple procedure for dealing with the low hairline by using a hinged mastoid fascial flap simultaneously with costal cartilage grafting is described. Read More

J Craniofac Surg 2016 Jan;27(1):44-50

*Faculty of Medicine and Dentistry, University of Alberta †Institute for Reconstructive Sciences in Medicine, Misericordia Hospital, Covenant Health Group ‡Division of Plastic and Reconstructive Surgery, University of Alberta, Edmonton, Canada.

Patients with major ear deformities and associated compromise of the superficial temporal artery are poor candidates for autogenous ear reconstruction because of a tenuous ipsilateral temporoparietal fascial flap (TPFF). Osseointegrated prosthetic auricular reconstruction (OPAR) is an alternative to contralateral free TPFF microsurgical and autogenous reconstruction, but data on clinical outcomes are limited. The records of patients with ear loss or major deformity and a compromised ipsilateral TPFF who underwent OPAR from 1989 to 2013 were reviewed. Read More

J Neurosurg 2016 08 27;125(2):419-30. Epub 2015 Nov 27.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

OBJECT The objective of this study was to describe the surgical anatomy and technical nuances of various vascularized tissue flaps. METHODS The surgical anatomy of various tissue flaps and their vascular pedicles was studied in 5 colored silicone-injected anatomical specimens. Medical records were reviewed of 11 consecutive patients who underwent repair of extensive skull base defects with a combination of various vascularized flaps. Read More

J Neurosurg Pediatr 2016 Mar 6;17(3):371-7. Epub 2015 Nov 6.

Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago; and 

The authors of this report present a pediatric case involving the use of a tunneled temporoparietal fascia flap to reconstruct a skull base defect for a multiply recurrent clival chordoma and cerebrospinal fluid leak, demonstrate the surgical technique through illustrations and intraoperative photos, and review the pertinent literature. A 9-year-old female patient underwent extensive clival chordoma resection via both the endoscopic and open approaches, which ultimately exhausted the bilateral nasoseptal flaps and other intranasal reconstructive options. Following proton beam radiation and initiation of chemotherapy, tumor recurrence was managed with further endoscopic resection, which was complicated by a recalcitrant cerebrospinal fluid leak. Read More

GMS Interdiscip Plast Reconstr Surg DGPW 2015 13;4:Doc01. Epub 2015 Jan 13.

Klinik für Plastische und Handchirurgie mit Schwerbrandverletztenzentrum, Klinikum St. Georg gGmbH, Leipzig, Germany.

Severe soft tissue defects as a result of lye contamination remain a huge challenge in the interdisciplinary approach of trauma surgeons and plastic surgeons. Free tissue transfer is a suitable surgical option for successful reconstruction of form and function of defects in the distal parts of the lower extremities. We report the successful two-stage reconstruction of a full thickness lye contamination at the dorsum of the foot with a free temporoparietal fascia flap covered with a split-thickness skin graft from the thigh. Read More

J Craniofac Surg 2015 Sep;26(6):e472-5

Plastic Surgery Hospital, Peking Union Medical College, Beijing, China.

Unlabelled: Reconstruction of complex facial defects using cervical expanded flap prefabricated by temporoparietal fascia flap.

Background: Complex facial defects are required to restore not only function but also aesthetic appearance, so it is vital challenge for plastic surgeons. Skin grafts and traditional flap transfer cannot meet the reconstructive requirements of color and texture with recipient. Read More

Ann Otol Rhinol Laryngol 2015 Dec 14;124(12):978-86. Epub 2015 Jul 14.

Department of Otolaryngology-Head and Neck Surgery, Southern California Permanente Medical Group, San Diego, California, USA

Background: External auditory canal exostoses are benign, bony overgrowths that arise in patients who experience chronic cold water exposure. While considerable advancement has been made in canalplasty techniques in recent decades, many patients continue to experience prolonged healing periods and recurrent stenosis following surgery.

Objective: To perform a retrospective outcomes analysis of our experience with a skin-preserving canalplasty technique with temporoparietal fascia grafting and use of bone wax for skin flap protection. Read More

J Craniofac Surg 2015 Sep;26(6):1930-2

Loma Linda University School of Medicine, Loma Linda, CA.

Reconstruction of microtia with autogenous costal cartilage that produces a well-projected ear in a single stage is a challenging endeavor. In this case report, we describe a single-stage, projected costal cartilage-based reconstruction of concha type mitoria. Due to the patient's low hairline, his hair-bearing scalp would encroach on the ear framework if placed subcutaneously in the standard fashion. Read More

J Craniofac Surg 2015 Jul;26(5):e390-2

*Department of Plastic Reconstructive and Aesthetic Surgery †Department of Ear Nose and Throat ‡Department of Plastic Reconstructive and Aesthetic Surgery, Mersin University Hospital, Mersin University School of Medicine, Mersin, Turkey.

Solitary fibrous tumors (SFTs) have been reported in various locations in the body. Solitary fibrous tumors are extremely rare tumors, especially when located in the orbit. Diagnosis of SFT cannot be made based on histopathology only because it exhibits a variable microscopic appearance, and necessitates immunohistochemistry to confirm the diagnosis. Read More

Laryngoscope 2016 Apr 27;126(4):826-8. Epub 2015 May 27.

Department of Surgery (Otolaryngology), Yale School of Medicine, New Haven, Connecticut, U.S.A.

Einstein (Sao Paulo) 2015 Jan-Mar;13(1):106-9. Epub 2015 Mar 3.

Hospital de Crânio e Face, Instituto de Cirurgia Plástica Craniofacial, Campinas, SP, Brazil.

The temporoparietal fascia flap has been extensively used in craniofacial reconstructions. However, its use for eyebrow reconstruction has been sporadically reported. We describe a successfully repaired hair-bearing temporoparietal fascia flap after traumatic avulsion of eyebrow. Read More

Head Neck 2015 Dec 14;37(12):E194-9. Epub 2015 Jul 14.

Department of Otolaryngology, University of Southern California, Keck School of Medicine, Los Angeles, California.

Background: We present a case of a 51-year-old male patient with pigmented villonodular synovitis (PVNS) of the left temporomandibular joint (TMJ) that initially presented as a slow-growing left facial mass. Upon further workup, a contrast-enhanced CT scan demonstrated an expansile soft tissue mass in the left TMJ.

Methods: The lesion was diagnosed through fine-needle aspiration biopsy. Read More

J Reconstr Microsurg 2015 Jun 24;31(5):336-42. Epub 2015 Mar 24.

Department of Otorhinolaryngology - Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.

Background: Sarcoma is the most common midface malignancy in children. While first-line treatment in adults is resection, the challenges associated with resection and reconstruction of these tumors in children often lead to radiation therapy as primary treatment. This report highlights the feasibility and efficacy of midface reconstruction in the pediatric population after resection. Read More

Burns Trauma 2015 27;3:16. Epub 2015 Sep 27.

Division of Plastic & Reconstructive Surgery, The Mount Sinai Medical Center, 895 Park Avenue, New York, NY 10075 USA.

The author reviews his pioneering work in aesthetic restoration of the severely disfigured burn face first introduced in 1995 and refined over the past two decades. The reader will be exposed to the step by step approach to achieving cosmetic enhancement and functional rehabilitation of advanced facial burns. The "keystone" of the autogenous reconstruction is the pre-patterned, sculpted microvascular free flap designed to fit like the "piece of a puzzle" into the aesthetic units of the face to replace disfiguring burn scars. Read More

Am J Otolaryngol 2015 Jan-Feb;36(1):97-102. Epub 2014 Oct 16.

ENT Center of Utah, Salt Lake City, UT. Electronic address:

Background: Reconstruction of composite oral cavity defects in the setting of prior surgery and radiotherapy presents a significant challenge. Although free tissue transfer has shown success in such situations, it is not without considerable risk. Regional pedicled flaps may provide a more suitable alternative. Read More

Neurosurg Focus 2014 ;37(4):E3

Departments of Neurological Surgery, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, Ohio.

Endoscopic expanded endonasal approaches (EEAs) to the skull base are increasingly being used to address a variety of skull base pathologies. Postoperative CSF leakage from the large skull base defects has been well described as one of the most common complications of EEAs. There are reports of associated formation of delayed subdural hematoma and tension pneumocephalus from approximately 1 week to 3 months postoperatively. Read More

Dermatol Surg 2014 Sep;40 Suppl 9:S113-9

*Department of Dermatology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland; †Department of Dermatology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio.

Background: Dermatologic surgeons may encounter challenging defects of the head and neck that are not amenable to repair with local flaps or grafts.

Objective: We offer a comprehensive review of the temporoparietal fascia flap (TPFF) and provide a step-by-step illustration of its application performed under local anesthesia for a challenging reconstructive scenario.

Materials And Methods: A 66-year-old male initially underwent Mohs micrographic surgery resulting in a large full-thickness defect at the postauricular scalp contiguous with a through-and-through defect of the upper right ear. Read More

J Indian Med Assoc 2013 Dec;111(12):852, 854

The temporoparietal fascia flap with its long rotational axis and extensive mobilisation properties, can provide vascularised tissue to repair the most distant areas in the orofacial region. The donor site morbidity is minimal with a well-concealed scar hidden in the hair-bearing scalp. However, the temporoparietal fascia flap is usually used together with a split thickness skin graft. Read More

Plast Surg (Oakv) 2014 ;22(1):22-5

Department of Plastic Surgery, Ain Shams University, Heliopolis, Egypt.

Background: Reconstruction of partial ear defects represents a difficult challenge to the plastic surgeon due to the delicate and intricate architecture of the chondrocutaneous sandwich of the external ear.

Methods: Fourteen patients with acute or previous traumatic subtotal loss of the upper one-third of the auricle were treated with autologous contralateral conchal cartilage graft and superficial temporoparietal fascia flaps.

Results: The symmetry of the reconstructed ears was satisfactory and the cosmetic appearance was acceptable for 13 patients. Read More

Oral Maxillofac Surg Clin North Am 2014 Aug;26(3):359-69

Department of Oral and Maxillofacial Surgery, University of Tennessee Medical Center, University of Tennessee Cancer Institute, 1930 Alcoa Highway, Suite 335, Knoxville, TN 37920, USA.

The temporal arterial system provides reliable vascular anatomy for the temporalis muscle flap and temporoparietal fascial flap that can support multiple reconstructive needs of the oral and maxillofacial region. The minimal donor site morbidity and ease of development of these flaps result in their predictable and successful transfer for reconstructive surgery of the oral and maxillofacial region. Read More