Temporalis myofascial flap in maxillofacial reconstruction: clinical and histological studies of the oral healing process

• Published in: British journal of oral & maxillofacial surgery Vol. 35; no. 6; pp. 406 - 412
• Main Authors: Cheung, L.K., Samman, N., Tideman, H.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Londonc Elsevier Ltd 01.12.1997; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Child; Cicatrix; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Jaw Neoplasms - rehabilitation; Jaw Neoplasms - surgery; Male; Maxillofacial surgery. Dental surgery. Orthodontics; Medical sciences; Middle Aged; Mouth Mucosa - physiology; Mouth Mucosa - surgery; Mouth Neoplasms - rehabilitation; Mouth Neoplasms - surgery; Oral Surgical Procedures - methods; Reconstructive Surgical Procedures - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps; Temporal Muscle - transplantation; Wound Healing; Human; Stomatology; Maxillofacial; Plastic surgery; Anatomical reconstruction; Striated muscle; Result; Oral cavity; Pedicle flap; Surgery; Technique; Fascia; Cicatrization
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1016/S0266-4356(97)90717-8

Objectives—To report our experience with temporalis myofascial flaps (TMF), describe the healing process of uncovered flaps in the mouth, and the histology of the repaired mucosa in the long term. Design—Prospective clinical and histological study. Subjects—36 patients who received a TMF over a 6.5 year period for serial assessment of the oral healing, 24 patients whose scars over the reconstructed area were assessed clinically, and 11 whose repaired mucosa was assessed histologically. Main outcome measures—To follow the clinical process of oral healing of the TMF and describe the repaired mucosa healed over the flap. Results—The uncovered TMF in the mouth healed gradually starting with an acute inflammatory phase, going through chronic inflammatory and proliferative phases with eventual epithelialisation of the oral mucosa. There were no major complications. The healed mucosa showed mild scarring in 70% of cases and the repaired mucosa had characteristic histological features that were distinct from the normal mucosa. Conclusion—The TMF is an extremely reliable and versatile flap for maxillofacial reconstruction which heals gradually with eventual coverage by mildly scarred repaired mucosa.