Dental and Medical Problems

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

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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

Abstract

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

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