Pedicled temporoparietal fascial flap reconstruction of select intraoral defects.
OBJECTIVE
Multiple modalities exist for reconstruction of oral cavity defects following resection. Although microvascular free tissue transfer is often the first choice for complex intraoral defect reconstruction, not all patients are suitable candidates for "free flaps." The authors present their experience with the pedicled temporoparietal fascial flap (TPFF) for reconstruction of selected intraoral defects.


METHODS
Retrospective chart review.


METHODS
Charts of patients who underwent a TPFF for reconstruction of intraoral defects at a tertiary academic institution between 2001 to 2003 were reviewed. Information regarding tumor, surgical procedure, complications, and results was gathered. The anatomy and surgical technique of using the TPFF for intraoral reconstruction were reviewed.


RESULTS
Three patients underwent reconstruction of an intraoral defect with a TPFF. All defects were on the lateral buccal space with significant anterior or posterior extension. All patients had specific contraindications for free flaps, including compromised donor site or recipient site vascularity and medical comorbidity. The procedures were uncomplicated. There was no incidence of flap failure, and all flaps accepted a split-thickness skin graft. The average hospital stay was 7 days. An oral diet was begun on the fifth postoperative day. The cosmetic result at the donor site was excellent. Follow-up has ranged from 7 to 30 months. Mild contracture of the flap developed in two patients, limiting mandibular motion.


CONCLUSIONS
The TPFF is a thin, vascular, durable flap that is a viable option for reconstruction of selected intraoral defects in patients who are not suitable candidates for other methods.
Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
Vijay K
VK
Nayak
Daniel G
DG
Deschler
D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004954:Esthetics; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009065:Mouth Rehabilitation / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D020858:Tissue and Organ Harvesting / Q000379:methods