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Updated: Aug 26, 2025

Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
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Optimizing Flap Harvest in Auricular Reconstruction.

Shanik J Fernando1, Seth J Davis1, Raj D Dedhia1,2,3

  • 1Department of Otolaryngology-Head and Neck Surgery.

The Journal of Craniofacial Surgery
|October 11, 2022
PubMed
Summary

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Optimal temporoparietal fascial (TPF) and occipital cranial fascial (OCP) flap design for auricular reconstruction requires specific dimensions. This study provides minimum measurements for robust flap elevation and successful alloplastic implant coverage.

Area of Science:

  • Plastic Surgery
  • Anatomy
  • Reconstructive Surgery

Background:

  • Temporoparietal fascial (TPF) and occipital cranial fascial (OCP) flaps are standard for alloplastic auricular reconstruction.
  • Optimizing flap design is crucial for successful implant coverage and patient outcomes.

Purpose of the Study:

  • To define optimal anatomical features for TPF and OCP flap design.
  • To establish minimum dimensions for adequate alloplastic implant coverage in auricular reconstruction.

Main Methods:

  • Performed 16 TPF and OCP dissections on 8 cadaveric specimens.
  • Documented vascular anatomy and key landmarks.
  • Measured minimum flap size for porous polyethylene implant coverage.

Main Results:

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  • Minimum average flap dimensions: TPF (11×8.3×6.4 cm) and OCP (13.1×8.6×6.5 cm).
  • Identified the "occipital elbow" landmark (8.2 cm posterior to external acoustic canal).
  • Noted vascular contributions from the occipital artery and mastoid emissary vein in the postauricular fascia.

Conclusions:

  • Anatomical insights guide optimal TPF and OCP flap design for auricular reconstruction.
  • Highlights the significance of arterial supply, the "occipital elbow" landmark, and postauricular fascia vascularity.
  • Provides essential minimum flap dimensions for successful alloplastic implant coverage.