Journal of Oral and Maxillofacial Surgery
Volume 68, Issue 3 , Pages 578-583, March 2010

The Use of the Temporalis Myofascial Flap in Oral Cancer Patients

  • Imad Abu-El Naaj, DMD

      Affiliations

    • Senior Surgeon, Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel
    • ,
  • Yoav Leiser, DMD, PhD

      Affiliations

    • Postdoctoral Fellow and Oral and Maxillofacial Trainee, Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Leiser: Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Haifa 35254, Israel
    • ,
  • Ronit Liberman, DMD

      Affiliations

    • Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel
    • ,
  • Micha Peled, DMD, MD

      Affiliations

    • Associate Professor, Head of Department, Department of Oral and Maxillofacial Surgery, Rambam Medical Center, and Faculty of Medicine, Technion, Haifa, Israel

published online 30 November 2009.

Purpose

The purpose of this article is to present our experience using the simple, reliable, and predictable temporalis myofascial flap (TMF) in rehabilitation and reconstructive surgery in cancer patients who are older and whose health is compromised in a way that precludes the use of microvascular free flaps.

Patients and Methods

Our series includes 10 patients (8 men and 2 women), ranging in age from 62 to 85 years (mean, 73.4 years). A full-thickness anteroinferiorly based TMF was used in 5 patients for palatal reconstruction, 3 patients for buccal lining reconstruction, and 2 patients for reconstruction after resection of facial skin and buccal mucosa.

Results

The TMF survival rate in this study was excellent, with an 80% success rate (2 minor complications). Complications included 1 case of a partial distally necrotic flap that resolved after local debridement and did not require further flap manipulation and 1 case of transient, spontaneously resolved facial nerve (temporal branch) palsy and limited mouth opening (<20 mm), which also resolved after judicious physiotherapy.

Conclusions

The TMF was found in this study to have a fairly low complication rate, was relatively easy to use, and had a predictable outcome. The proximity and reliability of the myofascial flap make it a favorable and highly recommended candidate for oral and maxillofacial reconstructive surgery in elderly patients, who usually have relatively poor recovery potential and decreased physiologic reserves.

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PII: S0278-2391(09)00568-0

doi:10.1016/j.joms.2009.04.068

Journal of Oral and Maxillofacial Surgery
Volume 68, Issue 3 , Pages 578-583, March 2010

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