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Sepsis of the cheek over a subcutaneous forehead flap
Plastic and Reconstructive Surgery
|March 1, 1980
Abstract:
In two cases, a temporal flap was folded medially and passed through a subcutaneous tunnel superficial to the parotid gland. In both cases sepsis developed at the point at which the flap entered the mouth. In one case a spontaneous perforation occurred and the other required drainage. If one elects to fold the flap medially and pass it superficial to the zygomatic arch, the route described by Lewis and Remensnyder, i.e., deep to the masseter, is preferable.
Insights
Temporal flaps passed superficially near the parotid gland can lead to sepsis and complications. A deeper surgical route, deep to the masseter muscle, is recommended for improved patient outcomes.
Area of Science:
- Head and Neck Surgery
- Surgical Techniques
- Reconstructive Surgery
Background:
- Temporal flaps are utilized in reconstructive surgery for head and neck defects.
- Surgical approaches for flap placement require careful consideration to minimize complications.
Observation:
- Two cases involved a temporal flap folded medially and tunneled subcutaneously superficial to the parotid gland.
- Sepsis occurred in both cases at the flap's entry point into the oral cavity.
Findings:
- One patient experienced spontaneous perforation of the flap site.
- The other patient required surgical drainage due to sepsis.
- The study suggests that a route deep to the masseter muscle, as described by Lewis and Remensnyder, is preferable when folding the flap medially superficial to the zygomatic arch.
Implications:
- These findings highlight potential risks associated with superficial temporal flap tunneling.
- The deep masseteric route may offer a safer alternative for medial temporal flap transposition.
- Surgeons should consider anatomical variations and potential complications when planning temporal flap reconstruction.