Superficial temporal recipient vessels in microvascular orbit and scalp reconstruction of oncologic defects

The superficial temporal artery and vein (STA/V) are often considered suboptimal recipient vessels due to anecdotal reports that they are unreliable and prone to spasm. This is unfortunate, as their position greatly facilitates reconstruction of the scalp and orbit. We present our experience with 28 patients who underwent microvascular craniofacial reconstruction of oncological defects using the STA/V as recipients over a 4-year period at a single institution. Rates of vessel thrombosis, total flap loss, and partial flap loss were not significantly different from 282 flaps anastomosed to neck vessels. With knowledge of the anatomy and proper technique, the STA/V are reliable and available in most patients and can facilitate microvascular orbit and scalp reconstruction. The proximity they offer allows more flexibility in flap pedicle length requirement and avoids the use of vein grafts. Caution should be exercised if there is a history of radiation therapy.