[Temporal muscle flap in cranio-facial reconstructive surgery. Apropos of 32 cases]

The temporalis muscle flap is used in craniofacial reconstructive surgery to repair defects, to restore facial contours and to cover bone grafts. These possibilities of reconstruction are analysed in the light of 32 cases. After reviewing the anatomy and the surgical technique, this series is presented as a function of the various types of defect: cranio-orbital (9 cases), defects of the malar area (6 cases), maxillary defects (7 cases), mandibular defects (7 cases), malar and parotid soft tissues defects (2 cases), mastoid defects (1 case). This study indicates that the temporalis flap possesses several advantages: great vascular reliability, associated with simplicity of flap raising and an easily available tissue volume. The arc of rotation constitutes the limiting factor. Romberg's syndrome does not constitute an ideal indication of choice, as the muscle may be atrophied. Similarly, when the defect requires thin cover, it would be wiser to use a thinner flap, such as fascia temporalis superficialis. Donor site sequelae are negligible. Limitation of mouth opening (3 cases) and frontal paralysis (2 cases) are usually transient. The field of application of this flap can be extended by continuing the flap as far as the pericranium or calvarium, allowing complex reconstructions.