Temporalis muscle flap: an alternative in oropharyngeal reconstruction

After resection of the ascending ramus of the mandible, the temporalis muscle is rendered functionless. It represents a viable and versatile bulk of tissue covered by stout fascia, which can be used in oral and oropharyngeal reconstruction after extensive excisional surgery. The surgical effort is reasonable, owing to the vicinity of the defect. The fascia, which resists the saliva, is left uncovered; epithelization is completed after 2 to 3 weeks. The cosmetic result is acceptable. Skin incisions are invisible because they are covered by hair; the flattening of the temporal fossa will be smoothed out by scarring after several months. The postoperative course was uneventful in 11 patients but for minor problems. The flap remained viable in all subjects. The temporalis muscle flap seems to be a valuable alternative among the techniques of oral and oropharyngeal reconstruction.