Temporal Vessels: An Established Recipient Site for Maxillofacial Microvascular Reconstruction? A Systematic Review and Meta-Analysis of Reported Outcomes.

Objectives: This systematic review and meta-analysis evaluated the clinical utility of superficial temporal vessels as recipient vessels for free flap reconstruction in the maxillofacial region. Given their favourable anatomy and potential advantages in previously treated or vessel-depleted necks, we synthesised available evidence on complication rates, flap viability, and recipient site morbidity. Material and Methods: Following PRISMA guidelines, a comprehensive literature search was performed. Studies were included if they reported outcomes of free flap maxillofacial reconstructions using temporal vessels for microvascular anastomosis. Primary outcomes were arterial and venous thrombosis or compromise, and overall vascular complications. Secondary outcomes included return to theatre, flap necrosis, salvage rates, and recipient site complications. A random-effects model was used for data pooling, and heterogeneity was assessed via the I Results: Twenty-one studies reporting 773 reconstructions in 759 patients were included. Arterial thrombosis/compromise occurred in 1.44%, venous in 5.13%, with an overall vascular complication rate of 7.24%. Return to theatre occurred in 7.72% and flap salvage in 4.23%. Partial and total flap necrosis rates were 2.14% and 4.05% respectively. Recipient site complications were reported in 10.43% of cases. Conclusions: Superficial temporal vessels demonstrate reliable outcomes with complication rates comparable to cervical vessels. Their use may reduce surgical morbidity and should be considered a viable primary recipient option in complex head and neck reconstructions.