TEMPORALIS MUSCLE FLAP - Vula - University of Cape Town

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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.
5Author & EditorJohan Fagan MBChB, FCORL, MMedProfessor and ChairmanDivision of OtolaryngologyUniversity of Cape TownCape TownSouth Africajohannes.fagan@uct.ac.zaFigure 12: Temporal fossa concavityDental rehabilitationThe Open Access Atlas of Otolaryngology, Head &Neck Operative Surgery by Johan Fagan (Editor)johannes.fagan@uct.ac.za is licensed under a CreativeCommons Attribution - Non-Commercial 3.0 UnportedLicenseDue to the absence of alveolar bone, it isnot possible to insert dental implantsfollowing inferior maxillectomyreconstruction. With bilateral inferiormaxillectomy, it is not possible to fit andretain an upper denture.Some useful references1. Moore EJ. Temporoparietal FasciaFlap. emedicine2. Smith J, Ducic Y, Adelson R. Theutility of the temporalis muscle flap fororopharyngeal, base of tongue, andnasopharyngeal reconstruction.Otolaryngol Head Neck Surg2005;132:373-80
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TEMPORALIS MUSCLE FLAP - Vula - University of Cape Town

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