Superficial temporal artery and vein as recipient vessels for facial and scalp microsurgical reconstruction.

Background: Although free flap transfer is commonly performed to reconstruct defects of the upper two-thirds of the face and scalp, the superficial temporal artery and vein have historically not been considered adequate for microsurgical reconstruction and have rarely been described as recipient vessels. The purpose of this study was to determine the indications for and effectiveness of using the superficial temporal vessels for scalp and face reconstruction.

Methods: Retrospective chart review on all patients undergoing microsurgical reconstruction for defects of the upper two-thirds of the face between 1996 and 2003 revealed 45 free tissue transfers in which the superficial temporal artery and vein were considered for use as recipient vessels. Flap success rates and postoperative course were evaluated.

Results: Forty-three patients underwent 45 free flap transfers. The superficial temporal artery was used as the recipient artery in every case. In three cases, the superficial temporal vein was not suitable as the recipient vein and required use of a vein in the neck. The median length of follow-up was 4 years. Flap survival was 96 percent. Five patients required reoperation for vascular compromise. One of these patients ultimately had flap failure. In that patient, a subsequent attempt at microvascular flap reconstruction was successful using the same superficial temporal artery and vein as recipient vessels.

Conclusions: Use of the superficial temporal artery and vein for scalp and face reconstruction is reliable and safe. The superficial temporal artery and vein should be considered as primary recipient vessels in microsurgical reconstruction of the upper two-thirds of the face and/or scalp.