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Facial Plast Surg Clin North Am. 2009 May;17(2):253-62. doi: 10.1016/j.fsc.2009.01.005.

Reconstruction of periauricular and temporal bone defects.

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Division of Otolaryngology, Head & Neck Surgery, Department of Surgery, University of Alabama School of Medicine, BDB 563, 1530 3rd Avenue South, Birmingham, AL 35294-0012, USA.


Large periauricular and temporal bone defects most commonly follow resection of advanced nonmelanoma skin cancers. Reconstruction aims to cover the cutaneous defect and adjacent vital structures with the ability to heal in an irradiated field and withstand further treatment. Preferred reconstructions are class I, cervicofacial rotation or radial forearm free flap; class II, anterolateral thigh; and class II, rectus abominis free flap. Ancillary procedures, especially for associated facial paralysis, often are required. Although free flap reconstruction provides rapid wound healing, local and regional flaps are alternatives for patients unable to tolerate prolonged anesthesia and for use after recurrence or complications.

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