Temporalis muscle flap for reconstruction of oral defects

Abstract

For defects in the oral and maxillofacial region, several varieties of flaps can be used. These include local, free, and regional flaps. Local flaps can be used successfully for small defects. They use local tissues adjacent to the defect and gain blood supply through small vessels in their base. They are usually described according to their geometry: rotation, transposition, and advancement flaps. However, for moderate to large defects, such as following tumor resections or following traumatic injury, free or regional flaps are often necessary to reconstruct such defects. While free flaps provide predictability and vascularity when the vascular supply to the recipient bed is deficient, the operative time, technical expertise, operative site, and occlusion of the pedicle are some of the potential problems associated with these flaps. On the other hand, regional flaps provide a viable alternative for reconstruction of defects in the oral and maxillofacial region with greater degree of predictability, adequate bulk, and minimal morbidity to the donor site. Of these flaps, the temporalis muscle provides one of the best options because of its reliability, vascularity, adequate bulk, and its proximity to defects in the oral and maxillofacial region. The flap can be used as a myofascial, myo-osseous, or myo-osseocutaneous flap. It has been used for reconstruction of various defects in the oral and maxillofacial region including defects of the base of the skull.