Reconstruction with Temporary Muscle Flap in the Absence of the Middle Third of the Facial Region - Our Experience in a Medium Complexity Hospital

Abstract

Introduction: Temporalis muscle vascularized flaps are a valid therapeutic option for the reconstruction of defects in the facial region after surgical resections. It is an acceptable alternative to free transfer flaps when these cannot be used because of the patient’s performance state and base pathologies. Or because of the lack of a microvascular surgeon.

Objectives: To describe experience applying this kind of flaps for the reconstruction of 7 patients, with defects in palate orbit and yugal mucose after respective surgeries for various pathologies.

Materials and methods: Retrospective revision of patients in the general department, of Jose R Vidal Hospital (Corrientes - Argentina) who underwent surgery during the period between January 2019 to January 2021. A total of 7 patients underwent immediate reconstructive surgery using a temporalis muscle flap.

Results: 7 patients (4 males and 3 females) underwent respective surgery for different malignant (6) and benign (1) with a median age of 60. Two flaps were used for defects of the orbitary region and soft tissue and, six for defects of the oral cavity (in one patient both temporalis muscles were used. The procedure was successful in all cases, and minor complications were presuppose-operatory pain, hematoma, trismus, excavation of the donor region) all procedures resulted in surgical margins of lesion of malignancy.

Discussion: Reconstructive surgery using a vascularized flap of temporalis muscle is an excellent alternative for regional flaps with good results and a high success justified because of its a good irrigation. Besides the proximity between temporalis muscle and the maxillofacial region, possibilities a flap rotation of up to 180 grades without compromising its vitality it is also useful for reconstruction in a single surgery shortening intra-operatory time while avoiding repositioning of the patients during the procedure.

Conclusions: Temporalis muscle flaps are a valid option to free osteo- mayo- cutaneal flaps for mixed defects (involving bone and soft tissue) of the medium third of facial region after resective surgeries when the latter cannot be carried and because of various aspects of little performance status base pathologies and lack of microvascular margin.