Preauricular Superficial Temporal Artery Flap: A Simple Solution in Face Reconstruction

Face reconstruction is exceptionally demanding for the best color and texture equivalence with minimal morbidity. Most defects result from tumors or trauma, and local flaps are typically used. A preauricular flap based on the superficial temporal artery (STA) is an alternative to the classically used retroauricular flap. We describe a case of an 80-year-old female presenting a frontotemporal squamous cell carcinoma and reconstructed with a preauricular superficial temporal artery (PASTA), reverse-flow, pedicled flap. It measured 5x6 cm and was based on the STA parietal branch instead of the more frequently reported frontal branch. The donor site was closed primarily. After 24 months, there were no complications, the aesthetic result was good, and the scar was inconspicuous. We also reviewed the literature for preauricular flap reports. A total of 152 preauricular STA flaps have been reported, mostly free flaps, for different facial areas, including ear cartilage or hair-bearing areas. Venous congestion is the most frequent complication. The PASTA flap is a simple solution for small-to-moderate facial defects, is easily harvested, has a straightforward dissection, can be reliably based on either a frontal or parietal branch, and provides an excellent texture and color match with minimal morbidity.