A 84-year-old woman was referred for recurrent squamous cell carcinoma in the right preauricular region, previously treated with surgery and radiotherapy.
On facial CT, a mass appears in the right preauricular region extending to the soft parts of the malar region, contacting the masseter muscle and parotid gland.
Surgical treatment consisted of excision of the lesion including the right ear, EAC and radical total parotidectomy.
The reconstruction was performed with a temporal muscle flap that was deinserted from the temporal crest and pediculate in the coronoids, rotated caudally to cover the defect.
The inferior portion of the deep temporal fascia was dissected and divided into two blades whose free ends were sutured to the commissure and upper lip muscles.
The transposed temporal muscle was covered with a partial skin graft.
Two months after surgery, the patient was able to elevate the commissure and achieve acceptable esthetics in the rectified area.
