The Anatomy Review And Clinical Application Of The Flap With Superficial Temporal Artery For Defects After Resection Of Facial Tumor

Objective:1.To study the anatomy of superficial temporal artery,therefore provide anatomical bases for the clinical effect;2.To explore the feasibility and clinical effect of using the flap with Superficial temporal artery for defects after resection of facial tumor.Methods: 1.Review of literature on superficial temporal artery anatomy,and understand the courser,main branches,variation,edge of blood supply,and the relationship with adjacent structures.dissect 2 adult cadavers(10%formaldehyde solution perfused and latex fixed),to observe the distribution and direction of branches of superficial temporal artery(STA);2.From June 2012 to November 2017,the flap with Superficial temporal artery was applied to repair the defects after resection of facial tumor in 59 cases,including 35 cases of male and 24 cases of female,whose age from 15 to85 years old(mean 58 years).including 21 cases of hair-matrix carcinoma,16 cases of squamous cell carcinoma,13 cases of Pigmented nevus,9 cases of Bowen’s disease.The tumor size ranged from 0.5 cm×1.0 cm to 4.0 cm×5.0 cm.The extended resection of the tumor tissue was performed according to the characters of tumor.Intraoperative frozen specimen was used to make sure no invasion at margin and wound base.According to the location and size and Peripheral vascular perforation of the defect,the flap with Superficial temporal artery was designed to repair the defect.Including12 cases of the Gourd-shaped flap with frontal branch of Superficial temporal artery,27 cases of superficial temporal artery island flap,11 cases of Superficial temporal artery dilatation island flap,9 cases of Temporal superficial fascia flap,Fascia flaps were covered by skin grafts.The flaps,size ranged from 2.0 cm× 5.0 cm to 12.0 cm× 7.0cm.Results:1.The trunk of the superficial temporal artery goes along the shallow Superficial fascia after perforating the loose fascia between the external auditory canal and the temporomandibular joint capsule,Crossing over gomatic arch,Keeps going upwards along the shallow epicranial aponeuroisis,the artery divided into Frontal branch and Pailetal branch.and the point is 3~4 cm away from the gomatic arch;the start part of Pailetal branch goes undder the shallow Superficial fascia,Arrivals in rear upper of parietal tuber.The start point of frontal branch is about 3 cm away from the front of the tragus,And the superficial temporal artery frontal branches can be divided into three categories according to their morphology and origin:The trunk having no branch,the trunk having branch and variant,The superficial temporal artery and the surrounding blood vessels form a rich perforator anastomosis network,and it has no typical associative relationship with superficial temporal veins,It is adjacent to the facial nerve branch but not in the same plane.2.All flaps with 59 cases of patients survived completely with primary healing and no complication,like facial paralysis or abnomal feeling,48 patients were followed up 3-36 months with inconspicuous scar and no tumor relapse.Satisfactory cosmetic and functional result can be achieved..The flaps had good match in color with the surrounding tissue.satisfactory appearance and functional result can be achieved.Conclusion:The flap with Superficial temporal artery has a reliable blood supply and flexible transverse method with satisfactory cosmetic result.It is one of the ideal method for reconstruction of ficial soft tissue defects.