Use of the pedicled superficial temporoparietal fascial flap for reconstructing soft tissue defects of oral cavity

The temporoparietal fascial flap is rarely described for the treatment of oral cavity loss of substances. In our experience, it is can a good alternative for the reconstruction of the lateral part of the oral cavity. The aim of this study is to describe the anatomical basis of this technique and to report our recent experience of this flap in this indication. Three fresh cadavers have been dissected in order to determine the maximal length of the flap and the best technique to pass the flap in the oral cavity. Two patients have been operated after surgical resection of an oral epidermoid carcinoma. In one case, the flap has been used to cover a loss of substance of the retromolar and internal cheek areas and in the second case to cover a lateral floor of the mouth loss of substance. The anatomical study showed that the feasibility of the flap was good, the surface of the flap was 12 x 12 centimetres, and the temporal ramus of the facial nerve was easy to preserve if the dissection was prudent in the anterior part of the flap. The clinical results were good, no necrosis of the flap and no facial paralysis were observed. In our opinion, this flap can be proposed to cover the lateral loss of substance of the oral cavity. The main advantages of this flap are the absence of visible scar of the donor site, this is a regional flap possible to harvest in the same surgical field, it is independent from the movements of the head and it can be a sensitive flap when the auriculo-temporalis nerve is harvested.