Use of Temporalis Myofascial Flap in Maxillary Reconstruction

Choubarga Nayak, Santosh Kumar Swain, Ashok Gupta
2014 Clinical Rhinology An International Journal  
Maxillary ameloblastoma is a benign odontogenic neoplasm. Excision should involve wide margins because of its high recurrence rate and ideally be followed by reconstruction. A 23 year-old female patient presented with recurrent ameloblastoma. One year previously, she had undergone a curettage excision. The recurrent lesion was managed by a total maxillectomy preserving the inferior orbital rim. Simultaneous reconstruction was performed with an temporalis myofascial flap for obliteration of the
more » ... bliteration of the maxillary sinus and nasal cavities. Reconstruction of mid facial defects after tumor resection or trauma has evolved from skin graft to pedicled flaps and more recently, to free tissue transfer. Each of these reconstructive modalities has its specific indications, advantages and drawbacks. Temporalis muscle is one of the regional flaps that can be used to reconstruct midfacial defects. The muscle is available close to the surgical field and has a constant vascular supply. However, the flap has a limited arc of rotation and most of the muscle bulk is used in the pedicle. Therefore, various modifications of the surgical procedure were attempted in order to increase the arc of rotation of the flap. The temporalis muscle flap can provide a reliable, one-stage reconstructive alternative for more complicated surgical procedures for moderate-sized midfacial defects. Dimensions and arc of rotation of the flap may be increased by using temporalis muscle and deep temporal fascia as a myofascial unit.
doi:10.5005/jp-journals-10013-1200 fatcat:p5bfuukfsbap5fpqjv53hbx4n4