Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2015, vol. 52, nr 2, April-June, p. 137–143

Publication type: original article

Language: English

Creative Commons BY-NC-ND 3.0 Open Access

Temporalis Muscle Flap in Mid-Facial Reconstruction

Płat mięśnia skroniowego w rekonstrukcji środkowego piętra twarzy

Krzysztof Sztychny1,A,B,C,D, Marcin Kozakiewicz1,A,C,E,F

1 Department of Maxillofacial Surgery, Medical University of Lodz, Łódź, Poland


Background. Immediate reconstruction after ablative surgery in the mid-facial region seems to be much more comfortable and functional than the conventional obturation methods of post-maxillectomy patient rehabilitation. Among the variety of flap reconstructions, the temporalis muscle flap (TMF) has been utilized for over a century as a relatively simple method of mid-facial restoration.
Objectives. The aim of this study was to present the operative technique and the authors’ clinical experience in the TMF reconstruction of mid-face defects.
Material and Methods. The study included 17 consecutive patients who had undergone ablative surgery with immediate TMF transposition: squamous cell carcinoma – 9, basal cell carcinoma – 2, carcinosarcoma – 1, sarcoma – 3, extrapulmonary type small cell carcinoma – 1, and malignant melanoma – 1.
Results. Less advanced tumors were diagnosed in the younger population (p < 0.01) and advanced cases had adjuvant radiotherapy significantly more frequent than low T-staged (p < 0.05). The local complications were not related to type of the TMF application. One oro-nasal fistula after our procedure, one partial necrosis of the myofascial flap without any functional complaint and two cases of post-operative trismus were observed. The extension of the harvested flap did not increase the number of local complications and no relationship between gender, suction drainage or post-operational CRP level to rate of complications were found.
Conclusion. The clinical evidence reveals the predicted and stable results. In our study, no major complications were observed. In conclusion, the procedure of raising the temporalis muscle flap is a relatively simple, safe, versatile and efficient method of reconstruction. According to the literature review and own experience, it seems to be an excellent alternative for free flaps in mid-facial reconstructions.

Key words

surgical oncology, maxillectomy, mid-facial reconstruction, temporalis muscle flap

Słowa kluczowe

chirurgia onkologiczna, resekcja szczęki, rekonstrukcja środkowego piętra twarzy, płat mięśnia skroniowego

References (19)

  1. Ahmed Djae K., Li Z., Li Z-B.: Temporalis muscle flap for immediate reconstruction of maxillary defects: Review of 39 cases. Int. J. Oral Maxillofac. Surg. 2011, 40, 715–721.
  2. Dallan I., Lenzi R., Sellari-Franceschini S., Tschabitscher M., Muscatello L.: Temporalis myofascial flap in maxillary reconstruction: anatomical study and clinical application. J. Craniomaxillofac. Surg. 2009, 37, 96–101.
  3. Golovine S.S.: Procédé de cloture plastique de l’orbite aprés l’exentération. Arch. d’Opht. 1898, 18, 679–684.
  4. Lentz J.: Résection du col du condyle avec interposition d’un lambeau temporal entre les surfaces de résection. Guérison. Assoc. Franc. de Chirur. 1895, 9, 113.
  5. Gillies H.D.: Plastic surgery of the face. Oxford Univ. Press, London 1920, 54–55.
  6. Campbell H.H.: Reconstruction of the left maxilla. Plast. Reconstr. Surg. 1948, 3, 66.
  7. Sheehan J.E.: The muscle nerve graft. Surg. Clin. N. Amer. 1935, 15, 471–482.
  8. Rosenthal W.: Über muskulare Neurotisation bei Facialislahmung. Zbl. Chir. 1916, 24, 489.
  9. Wong T-Y., Chung C-H., Huang J-S., Chen H-A.: The inverted temporalis muscle flap for intraoral reconstruction: its rationale and the results of its application. J. Oral Maxillofac. Surg. 2004, 62, 667–675.
  10. Clauser L., Curioni C., Spanio S.: The use of the temporalis muscle flap in facial and craniofacial reconstructive surgery. A review of 182 cases. J. Craniomaxillofac. Surg. 1995, 23, 203–214.
  11. Smith J.e., Ducic Y., Adelson R.: The utility of the temporalis muscle flap for oropharyngeal, base of tongue, and nasopharyngeal reconstruction. Otolaryngol. Head Neck Surg. 2005, 132, 373–380.
  12. Mani V., Panda A.K.: Versatility of temporalis myofascial flap in maxillofacial reconstruction – analysis of 30 cases. Int. J. Oral Maxillofac. Surg. 2003, 32, 368–372.
  13. Dexter W.S., Jacob R.F.: Prosthetic rehabilitation after maxillectomy and temporalis flap reconstruction: a clinical report. J. Prosthet. Dent. 2000, 283, 25–40.
  14. Rogers S.N., Lowe D., Mc Nalley D., Brown J.S., Vaughan E.D.: Health related quality of life after maxillectomy: a comparison between prosthetic obturation and free flap. J. Oral Maxillofac. Surg. 2003, 61, 174–181.
  15. Abubaker A.O., Abouzgia M.B.: The temporalis muscle flap in reconstruction of intraoral defects: an appraisal of the technique. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2002, 94, 24–30.
  16. Koranda F.C., Mc Mahon M.F., Jernstrom V.R.: The temporalis muscle flap for intraoral reconstruction. Arch. Otolaryngol. Head Neck Surg. 1987, 113, 740–743.
  17. Czechowska E., Kuras M., Sokalski J.: Acute phase proteins as inflammatory markers in selected diseases and in treatment attenuation in the oral cavity – literature review. Dent. Med. Probl. 2012, 49, 57–61.
  18. Bilewicz R., Bundgaard T., Burduk P.K.: Reconstruction after maxillectomy using the temporalis muscle flap – our experience. Otolaryngol. Pol. 2009, 63, 109–112.
  19. Del Hoyo A.J., Sanroman J.F., Gil-Diez J.L.: The temporalis muscle flap: An evaluation and review of 38 cases. J. Oral Maxillofac. Surg. 1994, 52, 143–147.