Temporoparietal Fascia and Temporalis Muscle Flaps for External Auditory Canal Reconstruction After Tumor Resection

Reconstruction of the external auditory canal (EAC) after malignant tumor resection requires functional, aesthetic, and radiation-resistant coverage. However, flap selection criteria remain lacking. The authors retrospectively reviewed 11 patients who underwent EAC reconstruction using a temporoparietal fascia flap (TPFF), temporalis muscle flap (TMF), or a combination of both between 2004 and 2025. Clinical data, surgical techniques, and outcomes were analyzed. Reconstruction procedures involved TPFFs alone (n=6), TMFs alone (n=2), and a combination of both (n=3). TMFs were used when the superficial temporal artery was sacrificed or when a TPFF alone was insufficient in volume. Skin grafts from the groin were used in all but 1 case. Seven patients received postoperative radiotherapy, with no radiation-related complications. TPFFs and TMFs, used alone or in combination, are safe and effective for EAC reconstruction. As reflected in our proposed algorithm, flap selection should be based on defect volume and vascular availability.