Closure of Large Oroantronasal Fistula Residual After Gunshot Injuries With Temporalis Muscle Flap

Abstract

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.

Current trends in the management of maxillofacial gunshot injuries: a critical review

“…Undermining of skin edges, usually a significant facilitator of primary closure, should be done very conservatively. Some massive soft tissue defects secondary to gunshot wounds require free tissue transfer 36 . Over the past decade, advances in microvascular technique have established free flap transfer as the gold standard in the reconstruction of severe facial trauma 18,[22][23][24]27 ; however, they are not used primarily 6,7,18,19 .…”