The use of the Temporalis Flap in Head and Neck Reconstruction

Introduction:

The use of the temporalis muscle in the reconstruction of the Head and Neck region is nowadays an established procedure. It has its indications in patients with poor prognosis or when reconstructive surgery using re-vascularized free flaps is refused by the patient or not possible. Also, it can be used in obliterations of fistulas involving the paranasal sinuses and the oral cavity or for the obliteration of the orbital cavity.

Patients and Methods:

From January 2004 to February 2017, 100 patients were treated in our departments for a variety of diseases. Most of them were oncologic conditions. A total of 104 temporal flaps were performed, in some cases we used a bilateral temporal flap for total maxillary reconstruction.

Results:

Only in two patients complications related to oral flap dehiscence were recorded. These cases did not require flap removal, although a longer period of secondary wound healing followed. Four patients developed transitory frontal nerve palsy.

Discussion:

The aspects that allow us to consider the temporal muscle as a choice for reconstruction of the upper and middle third of the maxillo-facial region are:

1) proximity to the area that requires reconstruction

2) its position and ease of mobilization

3) the extreme versatility due to the amount of tissue available.

Under these conditions, the pedicled temporalis flap is a favorable option for the reconstruction of the maxilla and the orbital cavity, as well as for anterior and middle cranial fossa reconstruction.

Conclusions:

The temporalis flap is a proven and reliable option for midfacial reconstruction. The use of a partial thickness flap is aesthetically favorable but it can be raised also in full thickness. Frontal and eyelid hypomobility can occur, which regresses within 20 – 40 days.

Publication History

Publication Date:
23 April 2019 (online)