Elevation of the temporoparietal fascial flap by conventional T or Y incisi
ons in the temporal region frequently leaves conspicuous scarring, hair thi
nning, or baldness. To avoid such undesirable effects, endoscopic-assisted
harvest of the temporoparietal fascial flap was performed in 9 patients wit
h microtia. Through two horizontal incisions in the temporal region, the te
mporoparietal fascia was dissected, and the flap was harvested using bipola
r scissors and coagulating shears. Flaps were dissected and harvested succe
ssfully without any complications in 7 patients, although extra incisions w
ere required to facilitate coagulation in 2 patients. The authors introduce
this harvesting technique and describe some representative cases. Using en
doscopic guidance, this is a versatile, safe procedure with minimal morbidi
ty, and is applicable to other reconstructive procedures that require a tem
poroparietal fascial flap, including the free flap.