title: Cadaveric dissection and clinical experience with 20 consecutive tunneled pedicled superficial temporal artery perforator (STAP) flaps for ear reconstruction.
abstract: BACKGROUND
  Reconstruction of anterior ear defects is poorly described, but using "like" tissue provides the optimal reconstruction. We present a cadaveric dissection and our experience with the pedicled superficial temporal artery perforator (STAP) flap for reconstruction of partial ear defects.
  
  
  METHODS
  Two cadavers were dissected bilaterally (n = 4) following injection of latex and barium sulfate. A retrospective review of 20 consecutive patients undergoing reconstruction with the STAP flap from 2009 to 2012 was performed. Twenty patients underwent reconstruction of anterior ear defects following resection for non-melanoma skin malignancies using a tunneled pedicled STAP flap (scapha: 5, triangular fossa: 2, scapha and triangular fossa: 13).
  
  
  RESULTS
  Two perforators were identified in all dissections with one perforator at the level of the tragus, and the second perforator within 1 cm cephalad to the tragus. Thirteen patients underwent reconstruction following basal cell carcinoma excision and seven patients were reconstructed following excision of squamous cell carcinoma. There were no flap losses, but four flaps (20%) developed congestion at the tip of the flap that resolved without need for flap delay, leeching, or vasodilators. No patients developed complications with the donor site, and no patients underwent revisions. With a mean follow-up of 27.3 months (range: 19-38 months), all patients were pleased with their aesthetic outcomes and alive without recurrent disease.
  
  
  CONCLUSIONS
  The STAP flap is a pedicled perforator flap providing local "like" tissue that can be utilized for resurfacing of defects involving the anterior upper external ear with minimal donor site morbidity.
authors.affiliation: Department of Plastic Surgery, Ospedali Riuniti di Ancona, Univerista' Politecnica delle Marche, Ancona, Italy; Department of Plastic Surgery, the University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Mario F
authors.initials: MF
authors.lastname: Scaglioni
authors.forename: Hiroo
authors.initials: H
authors.lastname: Suami
authors.forename: Giuliano
authors.initials: G
authors.lastname: Brandozzi
authors.forename: Daniele
authors.initials: D
authors.lastname: Dusi
authors.forename: Edward I
authors.initials: EI
authors.lastname: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004428:Ear Neoplasms / Q000601:surgery*; D004431:Ear, External / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D013699:Temporal Arteries / Q000033:anatomy & histology / Q000601:surgery*; D016896:Treatment Outcome