TEMPORALIS MUSCLE FLAP - Vula - University of Cape Town

4Figure 8: Reconstruction of inferiormaxillectomy defectFigure 10: Temporalis muscle filling theorbitNote in the Figure 9 how the muscle hasbecome covered with mucosa in a patientwith bilateral temporalis muscle flaps forbilateral inferior maxillectomy.Figure 11: Outcome of primary closure ofskin over temporalis muscle flapFigure 9: Mucosalised muscle followingpalatal reconstructionOrbital exenterationThe lateral wall of the orbit is removed toprovide space for passage of the musclepedicle. The orbit is filled with the TMF(Figure 10), and is covered with skin orsplit skin graft, or closed primarily if a lidhas been spared (Figure 11).Drawbacks of the temporalis muscleflapTemporal fossa concavity (Figure 12)The concavity of the temporal fossa fromwhich the muscle has been mobilized canbe quite pronounced. It may be filled witha fat graft or hydroxyappatite or mouldedprosthetic implants.