Reconstruction of a lower eyelid defect using the temporalis muscle

Massive defects of the cheek and simultaneous involvement of both eyelids preclude the use of local flaps and standard techniques for total lower eyelid replacement. Regional flaps may not provide enough coverage nor bulk, or they may require multiple delay procedures. Sagittal splitting of the temporalis muscle and anterior rotation of its lateral head deserves consideration for reconstruction of uncommon, large periorbital defects. A case is presented in which globe salvage was possible using this technique as a single stage procedure.