TY - JOUR
T1 - Pedicled Temporalis Muscle Flap for Craniofacial Reconstruction
T2 - A 35-Year Clinical Experience with 366 Flaps
AU - Spanio Di Spilimbergo, Stefano
AU - Nordera, Paolo
AU - Mardini, Samir
AU - Castiglione, Giusy
AU - Chim, Harvey
AU - Pinna, Vittore
AU - Brunello, Massimo
AU - Cusino, Claudio
AU - Roberto, Squaquara
AU - Baciliero, Ugo
N1 - Publisher Copyright:
Copyright © 2017 by the American Society of Plastic Surgeons.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background: In the past 130 years, the temporalis muscle flap has been used for a variety of different indications. In this age of microsurgery and perforator flaps, the temporalis muscle flap still has many useful applications for craniofacial reconstruction. Methods: Three hundred sixty-six temporalis muscle flaps were performed in a single center between 1978 and 2012. The authors divided the cases into two series - before and after 1994 - because, after 1994, they started to perform free flap reconstructions, and indications for reconstruction with a temporalis muscle flap were changed Results: In the series after 1994, flaps were most commonly used for reconstruction of defects in the maxilla, mandible, and oropharynx, in addition to facial reanimation and filling of orbital defects. Complications included total flap necrosis (1.6 percent) and partial flap necrosis (10.7 percent). The rate of material extrusion at the donor site decreased after porous polyethylene was uniformly used for reconstruction from 17.1 to 7.9 percent. Conclusions: The pedicled temporalis muscle flap continues to have many applications in craniofacial reconstruction. With increasing use of free flaps, the authors' indications for the pedicled temporalis muscle flap are now restricted to (1) orbital filling for congenital or acquired anophthalmia; (2) filling of unilateral maxillectomy defects; and (3) facial reanimation in selected cases of facial nerve palsy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
AB - Background: In the past 130 years, the temporalis muscle flap has been used for a variety of different indications. In this age of microsurgery and perforator flaps, the temporalis muscle flap still has many useful applications for craniofacial reconstruction. Methods: Three hundred sixty-six temporalis muscle flaps were performed in a single center between 1978 and 2012. The authors divided the cases into two series - before and after 1994 - because, after 1994, they started to perform free flap reconstructions, and indications for reconstruction with a temporalis muscle flap were changed Results: In the series after 1994, flaps were most commonly used for reconstruction of defects in the maxilla, mandible, and oropharynx, in addition to facial reanimation and filling of orbital defects. Complications included total flap necrosis (1.6 percent) and partial flap necrosis (10.7 percent). The rate of material extrusion at the donor site decreased after porous polyethylene was uniformly used for reconstruction from 17.1 to 7.9 percent. Conclusions: The pedicled temporalis muscle flap continues to have many applications in craniofacial reconstruction. With increasing use of free flaps, the authors' indications for the pedicled temporalis muscle flap are now restricted to (1) orbital filling for congenital or acquired anophthalmia; (2) filling of unilateral maxillectomy defects; and (3) facial reanimation in selected cases of facial nerve palsy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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U2 - 10.1097/PRS.0000000000003011
DO - 10.1097/PRS.0000000000003011
M3 - Article
C2 - 28121882
AN - SCOPUS:85010843591
VL - 139
SP - 468e-476e
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
SN - 0032-1052
IS - 2
ER -