Temporalis Myofascial Flap Research Articles

The epithelialization process in the healing temporalis myofascial flap in oral reconstruction

The aim of this study was to investigate prospectively the epithelialization process in the healing temporalis myofascial flap (TMF). Eight cats underwent maxillectomy and immediate reconstruction with TMF. They were killed at the determined time and the reconstructed maxillae were processed for examination by light microscopy and scanning electron microscopy. Results revealed that epithelialization of the healing TMF was initiated by hyperplastic changes followed by active migration of epithelial cells deriving from the wound margins. The partial maxillectomy wound was completely covered by a smooth oral mucosa at postoperative week 24. The mucosa had histological and ultrastructural features different from normal palatal mucosa.

Midface soft tissue reconstruction with the facio-cervico-pectoral flap

The reconstruction of large soft tissue defects in the orbital and maxillomalar region is a difficult task. A good functional and aesthetic result has to be achieved. The cervicopectoral rotation flap has many advantages; it is easy, rapid and safe to harvest, compatible with cervical dissection and radiotherapy. It is an anatomical unit, with skin properties similar to the rest of the facial skin. This is our pedicle flap of choice for large soft tissue defects in the midface, specially in elderly patients. We use it in association with the temporalis myofascial flap in cases of orbital exenteration. In large defects, the alternatives to these flaps are microsurgical free flaps or other pedicled flaps. These flaps require more complex techniques, are time consuming surgically, have greater morbidity and equal or worse functional and aesthetic results. In this paper we present our experience. Twenty-two patients with large soft tissue defects in the maxillomalar and orbital regions have had reconstructions with these flaps (facio-cervico-pectoral rotation flap and temporalis myofascial flap) in the last 8 years.

The role of the temporalis myofascial and pericranial flap in reconstruction of the orofacial region

The role of the temporalis myofascial and pericranial flap in reconstruction of the orofacial region

Intramuscular Temporalis Fascia

The purpose of this study is to demonstrate an intramuscular fascial layer within the temporalis muscle. This can be used as an inferior plane when developing a temporalis myofascial flap for temporomandibular joint reconstruction. The advantages of using this plane include relatively bloodless zone, adequate thickness of flap for reconstructive purposes, and residual temporalis muscle to prevent the temporal concavity deformity. Cadaveric and clinical examples are presented.

The use of the temporalis muscle flap in facial and craniofacial reconstructive surgery. A review of 182 cases

The authors report on their 16-year experience of reconstruction with the temporalis myofascial flap in 182 cases. All aspects of reconstructive cranio-maxillofacial surgery are covered: trauma, deformities, tumours, TMJ ankylosis, facial paralysis. The temporalis myofascial flap was used both as a single and as a composite flap with cranial bone, coronoid process or skin island. Major complications were not observed. On the basis of their experience, the authors confirm the reliability, versatility and reproducibility of the use of this flap. This is due both to its rich blood supply and to its proximity to the reconstruction site. It is suggested that the use of the temporalis muscle flap should be taken into consideration before deciding on more extensive reconstructive procedures.

The use of mouldable acrylic for restoration of the temporalis flap donor site

Despite the wide popularity of the pedicled temporalis myofascial flap, aesthetic management of the temporalis donor site has received little attention. A technique for immediate camouflage of the temporalis flap donor site with cold-cure methyl methacrylate, either alone or in combination with residual muscle in the temporal fossa, is presented. A retrospective evaluation of this technique in 34 consecutive patients was undertaken, with particular reference to the aesthetic results and morbidity associated with the use of cold-cure acrylic for this form of reconstruction. Apart from transient postoperative swelling and neuropraxia, no major or lasting complications associated with the use of cold-cure acrylic were recorded. The aesthetics of the camouflaged temporalis donor site by acrylic alone, or when combined with part of the temporalis muscle, was judged objectively to be excellent in 25 patients, satisfactory in 3 patients, and poor in 2 patients. 4 patients who did not have acrylic reconstruction, but had part of the temporalis muscle transposed to conceal the anterior fossa depression, leaving the posterior fossa unreconstructed, were judged mostly as satisfactory. Histology of the soft tissues around an acrylic implant after nearly 2 years confirmed the good biocompatibility of this material. It is concluded that this technique is a safe and reliable method for immediate camouflaging of the temporal fossa after harvesting a temporalis muscle flap.

RECONSTRUCTION OF DISCHARGING MASTOID CAVITIES USING THE TEMPORALIS MYOFASCIAL FLAP

Muscle obliteration of the troublesome mastoid cavity is one method of achieving a permanently dry ear, although long-term results are often disappointing. An operation is described, which is a modification of existing techniques and utilizes a temporalis myofascial flap. This procedure has been used on 46 discharging mastoid cavities and produced encouraging results. It provides a simple, safe and reliable solution to the problem.

Temporalis myofascial flap for maxillofacial reconstruction

To date, the temporalis myofascial flap has been used only to a limited extent for reconstruction in the maxillofacial region. Experience gained with 26 temporalis flaps in reconstruction of tissue defects in the periorbital region, skull base, maxilla, and oral cavity is presented. Only one patient developed total necrosis of the flap; significant necrosis did not occur in any other patient. The anatomy of the flap and surgical technique are briefly presented.

Transmaxillary temporalis transfer for reconstruction of a large palatal defect: Report of a case

The infratemporal transmaxillary transfer of a temporalis myofascial flap for reconstruction of an extensive palatal defect in an adult cleft palate patient is described. A modified temporal approach is discussed.

Correction of the deformities in treacher Collins' syndrome with a temporal myofascial flap and a silicone implant

The clinical features of Treacher Collins' Syndrome are described. A new operative procedure is presented using the temporal myofascial flap and a silicone implant to correct the malar hypoplasia; a local flap is used to correct the lower eyelid coloboma.

Temporalis myofascial repair of traumatic defects of the anterior fossa. Technical note.

Bilateral temporalis myofascial flaps in continuity with frontal periosteum can be used in repairing extensive dural and bone defects of the anterior cranial fossa floor. The technique of preserving and using this flap is described and offers an alternative to the use of frontal pericranial tissue for repair of anterior dural defects.