• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제28권1호
• /
• pp.69-73
• /
• 2002

Temporal muscle flap is usefull for the reconstruction of tissue defect at the oral and maxillofacial area. This article reports 3 cases of temporal muscle flap for the soft tissue reconstruction of infraorbital, palatal and mandibular retromolar area after tumor ablation. The advantages and disadvantage, postoperative complications and technical variations were reviewed and our 3 cases were evaluated in this aspects.

• Archives of Plastic Surgery
• /
• 제32권2호
• /
• pp.183-188
• /
• 2005

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권1호
• /
• pp.1-11
• /
• 1994

The functional deformity following removal of the maxilla is considerable, especially following maxilla cancer excision. Rehabilitation of oral and maxillofacial region used to be very difficult with prosthesis or traditional flaps. Temporal muscle and fascia flaps have been described for immediate reconstruction following hemi-maxillectomy, but not total maxillectomy. The muscle and superficial fascia of the temporal area differ in their physical characteristics, vascular supply and clinical applications. Both can be employed independently or simultaneously as regional flaps in the reconstruction of a variety of complex craniofacial defects. Four case is presented in which 3 case maxilla cancer, one case non-union after maxilla fracture, and all case showed successful use of this flap. Only one patient developed partial necrosis of the flap ; significant necrosis did not occur in any other patient. This present paper reviews the anatomy, surgical technique and utilisation of temporal muscle and fascia flaps.

• 대한두경부종양학회지
• /
• 제11권1호
• /
• pp.47-55
• /
• 1995

A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

• Archives of Reconstructive Microsurgery
• /
• 제14권2호
• /
• pp.95-104
• /
• 2005

The aim of this study was to investigate the major vascular system to supply flap, flap survival rate and complications after flap elevation in order to evaluate possibility of the vascularized face/scalp allotransplantation. Forty New Zealand white rabbits were divided into two groups: control group and experimental group. Individuals of control group had a face/scalp composite unit which was composed of skin, subcutaneous tissue and platysma muscle, supplying by bilateral facial artery, temporal artery and auricular artery and draining by external jugular vein. After a flap was elevated, bilateral facial artery, temporal artery and auricular artery were ligated. On the other hand, those of experimental group had the same composite unit as control group with bilateral facial artery, temporal artery and auricular artery being not ligated. We had measured survival area of flaps of the sixteen individuals survived for four weeks in the control group and fourteen in the experimental group by Grid method. The mean survival durations of the flap were 3.7days in the control group, 20.0days in the experimental group. The significant differences in the mean survival durations and survival rate at the 28days were found between the control and experimental group (p<0.05). Mean values about the survival area's fractions of all were $1.3{\pm}4.%$ in the control group and $63.1{\pm}4.8%$ in the experimental group. Those of experimental group was significantly higher than control group statistically (p<0.05). The composite face/scalp flap which we have elevated, supplied by bilateral facial artery, temporal artery, auricular artery and drained by external jugular vein has flap viability enough to be transplanted after its elevation.

• 대한두개안면성형외과학회지
• /
• 제12권1호
• /
• pp.37-42
• /
• 2011

Purpose: Cancer arising from the external auditory canal is a rare disease. A lesion that seems harmless in someway, can be lethal when inadequately excised, the tumor may infiltrate nerves, the parotid and auditory tissues before re-invading the skin. Wide resection of the lesion surrounding the structure and reconstruction with an adequate plan is crucial for the treatment of this disease. Methods: Two patients with external auditory canal cancer were treated with muscle flaps and skin grafts. Lateral temporal bone resection (LTBR) was performed for complete resection of the cancer. The defect cavity was obliterated with highly vascularized tissue using pedicled sternocleidomastoid muscle, and temporalis muscle individually, combined with full thickness skin graft for covering the skin defect of the ear. Results: Clear resection margin was obtained, and both patients showed disease free survival during the follow up. There was no complications of hematoma, infection, flap loss, or wound problem in both patients. Both patient received radiation therapy, there was no osteoradionecrosis or any other complication related to radiation therapy. Conclusion: Utilizing pedicled muscle flaps for managing defects after wide resection of the external auditory canal cancer is an effective method for managing this difficult disease.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제15권1호
• /
• pp.11-20
• /
• 1993

Bony ankylosis is an intraarticular condition where there is fusion of the bony surfaces of the joint : The condyle and the glenoid fossa. It occurs in both children and adults, unfortunately more frequently in the former, in whom early recognition and correction is particularly critical. Trauma is well proven to be the predominant cause of TMJ ankylosis. Infection, rheumatoid arthritis and neoplasm are another, significant cases of TMJ ankylosis. The necessity for using an interpositional material to prevent TMJ reankylosis has been widely discussed and many interpositional materials have been used, including temporal muscle and fascia, dermis, auricular cartilage, fascia lata, fat, Lyo-dura, Silastic and various metals. The temporal muscle and fascia have been widely used pedicled flap for head and neck reconstruction. The use of a temporal muscle and fascia for reconstruction of the TMJ, particularly in cases of ankylosis is a very reasonable option. Its principle advantages are its autogenous nature, resilience, and proximity to the joint, allowing for a pedicled transfer of vascularized tissue into the joint area. However, the viability of temporal muscle and fascia is a critical question. We treated 2 cases of TMJ ankylosis with temporal muscle and fascia transfer and one case with temporal fascia. We obtained satisfactory results as to functional aspects.

• 대한두개안면성형외과학회지
• /
• 제20권2호
• /
• pp.126-129
• /
• 2019

Traditionally, a galeal flap has been used for skull base reconstruction. In addition to the galeal flap, several other flaps, such as the temporalis muscle flap or the free vascularized flap, can be options for skull base reconstruction, and each option has advantages and disadvantages. Certain cases, however, can be challengeable in the application of these flaps. We successfully managed to cover a skull base defect using an extended temporalis flap. Herein, we present the case and introduce this novel method.

• Archives of Plastic Surgery
• /
• 제47권1호
• /
• pp.88-91
• /
• 2020

Cutaneous squamous cell carcinoma (SCC) is the second most common skin malignancy. This report describes the case of an unusual extensive SCC involving the whole hemiface, which required reconstruction with a combination of a dual vascular free transverse rectus abdominis muscle (TRAM) flap and a skin graft. A 79-year-old woman visited our hospital with multiple large ulcerated erythematous patches on her right hemiface, including the parieto-temporal scalp, bulbar and palpebral conjunctiva, cheek, and lip. A preliminary multifocal biopsy was performed in order to determine the resection margin, and the lesion was resected en bloc. Orbital exenteration was also performed. A free TRAM flap was harvested with preserved bilateral pedicles and was anastomosed with a single superior thyroidal vessel. The entire TRAM flap survived. The final pathological examination of the resected specimen confirmed that there was no regional nodal metastasis, perineural invasion, or lymphovascular involvement. The patient was observed for 6 months, and there was no evidence of local recurrence. Usage of a TRAM flap is appropriate for hemifacial reconstruction because the skin of the abdomen matches the color and pliability of the face. Furthermore, we found that the independent attachment of two extra-flap anastomoses to a single recipient vessel can safely result in survival of the flap.

• 대한두개안면성형외과학회지
• /
• 제19권2호
• /
• pp.94-101
• /
• 2018

Background: Atrophy of muscle and fat often contributes to temporal hollowing after pterional craniotomy. However, the main cause is from the bony defect. Several methods to prevent temporal hollowing have been introduced, all with specific limitations. Autologous bone grafts are most ideal for cranial defect reconstruction. The authors investigated the effectiveness of bony defect coverage and temporal augmentation using pterional craniotomy bone flap. Methods: This study was conducted in 100 patients who underwent brain tumor excision through pterional approach from 2015 to 2016. Group 1 underwent pterional craniotomy with temporal augmentation and group 2 without temporal augmentation. In group 1, after splitting the calvarial bone at the diploic space, the inner table was used for covering the bone defect and as an onlay graft for temporal augmentation. The outcome is evaluated by computed tomography at 1-year follow-up. Results: The mean operative time for temporal augmentation was 45 minutes. The mean follow-up was 12 months. The ratio of temporal thickness of operated side to non-operated side was 0.99 in group 1 and 0.44 in group 2, which was statistically different. The mean visual analogue scale score was 1.77 in group 1 and 6.85 in group 2. Conclusion: This study demonstrated a surgical technique using autologous bone graft for successfully preventing the temporal hollowing and improved patient satisfaction.