The Temporalis Muscle Flap for Palate Reconstruction: Case Series and Review of the Literature

Abstract

Introduction The temporalis myofascial (TM) is an important reconstructive flap in palate reconstruction. Past studies have shown the temporalis myofascial flap to be safe as well as effective. Free flap reconstruction of palate defects is also a popular method used by contemporary surgeons. We aim to reaffirm the temporalis myofascial flap as a viable alternative to free flaps for palate reconstruction. Objective We report our results using the temporalis flap for palate reconstruction in one of the largest case series reported. Our literature review is the first to describe complication rates of palate reconstruction using the TM flap. Methods Retrospective chart review and review of the literature. Results Fifteen patients underwent palate reconstruction with the TM flap. There were no cases of facial nerve injury. Five (33%) of these patients underwent secondary cranioplasty to address temporal hollowing after the TM flap. Three out of fifteen (20%) had flap related complications. Fourteen (93%) of the palate defects were successfully reconstructed, with the remaining case pending a secondary procedure to close the defect. Ultimately, all of the flaps (100%) survived. Conclusion The TM flap is a viable method of palate defect closure with a high defect closure rate and flap survival rate. TM flaps are versatile in repairing palate defects of all sizes, in all regions of the palate. Cosmetic deformity created from TM flap harvest may be addressed using cranioplasty implant placement, either primarily or during a second stage procedure.

Reconstruction of midface defect with temporalis myofascial pedicle flap: a review and case series

“…Although, an obturator may still be selected over, surgical reconstruction intentionally as the tumour bed needs to be left open for observation and under these circumstances the patient will have to comply. 7 Nasal regurgitation was not a post-operative complication in our patients as the TMPF separated the oral and nasal cavities. The patients were referred to prosthodontic department for occlusal rehabilitation after healing.…”

“…Literature reports flap necrosis of 1% with success after surgical debridement. 7 The largest case series reported by Wang et al, 8 & Browne et al, 6 of 67 and 72 patients respectively reported the continues viability of the TMPF for mid face defect reconstruction. 8,9 Our case series is in tandem with these studies showing the excellent versatility of the Temporalis flap for reconstruction of buccal mucosa, closure of oral antral fistula or to cover the defect after orbital exenteration.…”

Taking a step down on the reconstruction ladder for head and neck reconstruction during the COVID-19 pandemic

“…Tara Brennan et al and Jesse E et al showed very good results of temporalis muscle flap for reconstruction of palatal and tongue base defects. It has a high success rate and an outstanding alternative in the reconstruction of difficult intra-oral defects [ 45 , 46 ]. In cases where a hair-free and less bulky flap is needed, temporalis muscle flap has superior results over the pectoralis major muscle flap [ 47 ].…”

Locoregional Flap Reconstruction Following Oromaxillofacial Oncologic Surgery in Dogs and Cats: A Review and Decisional Algorithm

“…Coverage by a smooth oral mucosa was achieved in experimental cats 18-24 weeks after surgery (116). Indications of temporalis muscle flap in humans comprise the repair of defects involving the ipsilateral maxilla and palate, the lateral oropharyngeal wall and the retromolar area (117,118). So far, there is limited documentation of the clinical use of this flap to repair large oronasal fistula in dogs and cats.…”