An Unexpected Donor Site Complication after Aesthetic Rhinoplasty: Arteriovenous Fistula of the Superficial Temporal Artery

Reconstruction of traumatic defects on the scalp can be challenging. In cases of skull trauma, direct incisions close to bony defects can lead to skin and soft tissue necrosis. To minimize hair damage after surgery and to achieve both reconstructive and cosmetic effects, we propose a superficial temporal artery based pedicled flap for complicated traumatic cranial defects and lacerations. In the present case, a 21-year-old woman suffered intracranial hemorrhage with multiple skin and soft tissue injuries on her scalp after a violent attack. Neurosurgeons made a bicoronal incision for intracranial surgery and cranioplasty with a meshed plate, however 3×2.5 cm skin and soft tissue necrosis occurred on the mid-scalp near the vertex with plate exposure. We therefore elevated a 15×8 cm-sized pedicled flap based on a unilateral superficial temporal artery and transferred it to the defect without tension. The donor site was closed in a V-Y advancement pattern. Healing was uneventful, with good hairline and hair growth patterns observed. From our experience, we suggest a superficial temporal artery pedicled flap for complicated traumatic scalp defects.

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

Dentistry Journal ◽

10.3390/dj8040117 ◽

2020 ◽

Vol 8 (4) ◽

pp. 117

Author(s):

Raffaele Rauso ◽

Giovanni Francesco Nicoletti ◽

Enrico Sesenna ◽

Carmelo Lo Faro ◽

Fabrizio Chirico ◽

...

Keyword(s):

Soft Tissue ◽

Surgical Outcomes ◽

Donor Site ◽

Superficial Temporal Artery ◽

Temporal Artery ◽

Donor Site Morbidity ◽

Soft Tissue Reconstruction ◽

Facial Soft Tissue ◽

Artery Perforator ◽

Surgical Option

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.

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Traumatic arteriovenous fistula of the superficial temporal artery

Jornal Vascular Brasileiro ◽

10.1590/jvb.2014.008 ◽

2014 ◽

Vol 13 (1) ◽

pp. 39-42 ◽

Cited By ~ 1

Author(s):

Otacílio de Camargo Júnior ◽

Márcia Fayad Marcondes de Abreu ◽

Guilherme Camargo Gonçalves de Abreu ◽

Sthefano Atique Gabriel ◽

Isabella Maria Machado da Silva

Keyword(s):

Arteriovenous Fistula ◽

Superficial Temporal Artery ◽

Temporal Artery ◽

Surgical Removal ◽

Conventional Surgery ◽

Arteriovenous Fistulae ◽

Motorcycle Accident ◽

Pulsatile Mass ◽

Endovascular Methods ◽

The Right

Arteriovenous fistulae of the superficial temporal artery are rare, and their principal cause is traumas. Complications include pulsatile mass, headache, hemorrhage and deformities that compromise esthetics. Treatment can be performed using conventional surgery or endovascular methods. The authors describe a case of a 44-year-old male patient who developed a large pulsating mass, extending from the preauricular region to the right parietotemporal and frontal regions after a motorcycle accident. The treatment chosen was complete surgical removal of the pulsatile mass and ligature of the vessels feeding the fistula.

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