Tips and tricks of temporo-parietal fascial flap in post burn ear reconstruction

•Post burn ear reconstruction is challenging.•There is cartilage framework destruction, skin pocket and surrounding skin scarred.•Variable anatomy of temporal region especially superficial temporal vein.•Temporoparietal flap dissection in accurate plane most important for successful result.•Initial sub-follicular dissection with preservation of fat around hair follicles important to prevent scalp alopecia. Temporoparietal fascial flap (TPFF) is one of the most versatile flaps for facial reconstruction. TPFF can be used as a locoregional flap for various indications to provide effective and robust cover. In this article we shall discuss the tips and tricks of TPFF which we have used extensively for post burn ear reconstruction in our clinical experience of more than 20 years with consistent results. This is a retrospective review of 497 cases of post burn ear reconstruction using pedicled Temporoparietal fascial flap done at Department of Plastic and Reconstructive Surgery, Lok Nayak Hospital, which is tertiary care Government hospital in New Delhi from March 2000 to March 2020. We started use of this flap initially for ear reconstruction (microtia) cases and slowly expanded our indications over the period of time to post burn ear reconstruction apart from others due to its high vascularity and versatile nature. We have used pedicled Temporoparietal fascial flap to our advantage with varied indications and excellent results. We had minor complications which were easily managed with 11 cases of partial flap loss and one case of total flap loss. We shall discuss all the details in our review. We wish to conclude that pedicled Temporoparietal fascial flap (TPF) is an excellent versatile flap which can be easily molded over irregular contours and yields good long-standing results with low complication rates.