The Temporoparietal Fascial Flap: A Versatile and Reliable Tool in Craniofacial Reconstruction

Background: The superficial temporal artery (STA) supplies the temporoparietal fascial flap (TPFF), a thin, flexible, well-vascularized fascial flap.Because of its distinct anatomical characteristics, it is particularly well-suited for craniofacial restoration, where intricate three-dimensional abnormalities require thin yet durable coverage.Despite its adaptability, the TPFF is still underutilized due to donor-site morbidity concerns and a lack of knowledge about its full reconstructive potential.Objectives: This study describes the indications, surgical techniques, and clinical outcomes of TPFF reconstruction in a retrospective craniofacial case series.Methods: Thirty patients who underwent craniofacial reconstruction using the TPFF at our institution between January 2014 and December 2025 were retrospectively reviewed.Data on patient demographics, defect etiology, flap dimensions, operative technique, postoperative complications, and functional and aesthetic outcomes were analyzed.Results: Thirty patients were included: 18 males (18/30, 60.0%) and 12 females (12/30, 40.0%).The mean age was 28.2 ± 23.5 years (range: 7-75 years).Indications included auricular reconstruction in 15 patients (15/30, 50.0%), orbital/facial reconstruction in five (5/30, 16.7%), scalp/calvarial reconstruction in five (5/30, 16.7%), and skull-base reconstruction in five (5/30, 16.7%).Flap-related complications occurred in four patients (4/30, 13.3%), including partial flap necrosis in three (3/30, 10.0%) and complete flap loss in one (1/30, 3.3%).No wound infections or facial nerve injuries were documented.At a mean follow-up of 12 months, complete flap survival without necrosis was observed in 26 patients (26/30, 86.7%), while flap viability without complete flap loss was observed in 29 patients (29/30, 96.7%).Conclusions: For a variety of craniofacial abnormalities, the TPFF represents a dependable and adaptable choice for reconstruction, and careful surgical technique may help reduce donor-site problems.