Large oroantronasal fistulas have a detrimental effect on patient nutrition and speech, not to mention its moral effect when combined with devastating deformity associated with high-energy gunshot injuries to the face. Despite the fact that temporalis muscle flap was first described nearly 116 years ago, it still represents a useful tool in craniofacial and oral reconstruction. The aim of this article was to describe the utilization of temporalis muscle flap for reconstructing large oroantronasal fistula residual after gunshot injuries. Three clinical cases were described with emphasis on surgical technique. The flap was reliable because of its rich blood supply and close proximity to the oral cavity. Major complications were not observed. In hospitals lacking facilities for extensive reconstructive procedure, temporalis muscle flap should be taken into consideration when tackling difficult oral defects.
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