Salvage of Intraoral Dehiscence With a Superficial Temporal Artery Islandized Flap (STAIF)

Intraoral dehiscence compromises free fibula flaps following mandibular reconstruction. Salivary contamination risks thrombosis of microvascular anastomosis and hardware infection. The superficial temporal artery islandized flap (STAIF) provides a non-microsurgical reconstructive option for regainin...

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Bibliographic Details
Published inCurēus (Palo Alto, CA) Vol. 16; no. 4; p. e58049
Main Authors Mailey, Brian A, Sparkman, Blake M, Sinha, Alina K, Daugherty, Timothy
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 11.04.2024
Subjects
Case reports
Dissection
Medicine
Mouth
Ostomy
Reconstructive surgery
Thrombosis
Tracheotomy
Veins & arteries
United States > US
Illinois
Kansas City Missouri
free fibula flap
intraoral dehiscence
facial trauma
mandibular reconstruction
superficial temporal artery islandized flap
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Summary:Intraoral dehiscence compromises free fibula flaps following mandibular reconstruction. Salivary contamination risks thrombosis of microvascular anastomosis and hardware infection. The superficial temporal artery islandized flap (STAIF) provides a non-microsurgical reconstructive option for regaining intraoral competency for a time-sensitive complication. The STAIF is based on the superficial temporal artery coursing along the anterior hairline. The flap is mapped with the assistance of the Doppler probe. The width of the skin paddle is dependent upon the ability to close the donor site. The flap is taken down to the level of the zygomatic arch and tunneled into the mouth. We present a case of a patient who underwent mandibular reconstruction with a free fibula flap after a traumatic shotgun wound. The patient developed repeated intraoral dehiscence following failed local buccal and floor of mouth flaps leading to salivary contamination of the flap and hardware. The intraoral dehiscence was successfully salvaged on the third attempt with a STAIF. Intraoral dehiscence requires urgent attention to prevent loss of the free fibula flap after mandibular reconstruction. The STAIF is a non-microsurgical option for restoring intraoral competency. This robust, axially vascularized skin paddle may be split for intra- and extraoral coverage, as was performed in this case, and is an essential tool in the reconstructive armamentarium.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.58049