The temporalis muscle flap in contemporary oral and. Original article simultaneous anterolateral thigh flap and temporalis tendon transfer to optimize facial form and function after radical parotidectomy. Indications the anterior pericranial and galeofrontalis flaps have been used extensively for anterior skull base and craniofacial reconstruction. Temporoparietal fascial flap in orbital reconstruction. Most commonly used regional myofascial flaps for midfacial defects are cervicofacial rotation flap, forehead flap 8, and temporalis muscle flap. The new reconstruction technique in the treatment of the. The versatility of temporalis myofascial flap in maxillo. This type of flap preserves their arterial and venous vascularization and is rotated into the defect. It is a broad, fanshaped muscle on each side of the head that fills the temporal fossa, superior to the zygomatic arch so it covers much of the temporal bone.
The temporalis muscle is usually used in skull base reconstruction fig. The anatomy and surgical technique of the temporalis myofascial flap has been well documented. Oct 29, 20 temporalis muscle flap for the reconstruction oro facial defects case reportsoral sugery certified fixed orthodontic courses by indian dental academy 1. Original article the application of reverse tubular medial upper arm flap in the reconstruction of ripped facial defects xianglin dong 1, juan ma, shaolin ma, hao wen2 1department of burns and plastic surgery, the first affiliated hospital of xinjiang medical university, urumqi. Split temporalis muscle flap anatomy, vascularization and. The trapezius, pectoralis major and temporalis are the three most commonly used pedicled rotational flaps in head and neck surgery.
Jan 12, 2015 the temporalis flap remains as one of the reconstructive options for patients with facial paralysis. Temporalis muscle flap for reconstruction of skull base defects. Temporal fascia medical animation gross anatomy of head and neck, dr g bhanu prakash duration. The anatomical basis for surgical preservation of temporal. The temporalis osteomyoperiosteal flap its blood supply. Temporalis muscle flap for the reconstruction orofacial defects case reports indian dental academy leader in continuing dental education. The pedicled temporalis muscle flap is a reliable and highly versatile flap that receives blood supply from the anterior and posterior deep temporal arteries, which arise from the internal maxillary system deep to the zygomatic arch. The temporalis muscle lies deep to the temporoparietal fascia. Free flap 1 patients 73 obturator 40 free flap comparable postoperative speech and diet except for large defects function improved with free flap for large defects no change in time to recurrence moreno et al. A dynamic treatment of lagophthalmos is the temporalis muscle transfer tmt procedure as described by gillies 7. The vascular supply is the deep temporal artery, which originates from the internal maxillary artery fig.
Trauma, previous surgery, irradiation, or carotid occlusion may jeopardize the integrity of the temporoparietal fascia flap. Defects in the anterior lamella of the eyelids can be readily repaired with skin grafts or flaps but posterior lamellar reconstruction needs more complex applications. Temporalis muscle flap and temporoparietal fascia flap ento key. Original article simultaneous anterolateral thigh flap.
Then the prepared flap was filled and sutured in the space as an interpositional graft figure 3a, 3b. Topographical variations of the course taken by the frontal branches of the facial nerve were studied and are described in this report. The temporalis muscle flap tmf is a valuable reconstructive technique utilized in a variety of challenging defects. We performed posterior lamellar eyelid reconstruction with posterior parts of. Treatment of temporomandibular joint ankylosis with.
The temporalis muscle flap comprises the temporalis muscle, with or without the overlying temporalis fascia. Hemimaxillectomy for desmoplastic ameloblastoma with immediate temporalis flap reconstruction. The middle lateral bundle is a thin muscle layer covering the aponeurosis in the middle of the main portion. The following case log coding recommendations have been provided in an attempt to establish some. Jun 04, 2018 in 1898, the temporoparietal fascia flap was described nearly simultaneously for reconstruction of the external ear after a horse bite and for reconstruction of the lower eyelid. Adelson, md4 1department of otolaryngologyhead and neck surgery, university of texas southwestern medical center. Jun 04, 2016 two of these, the temporoparietal tp fascia and temporalis flaps, are most commonly used for reconstructing defects in the head and neck because of their proximity, reliability, and adaptability.
A temporalis fascial flap with a size about 6 cm3 cm was prepared, of which the anatomy and surgical technique has been well documented 4. The flap is plane, easy to form and contrary to skin flaps has no hair. Aug 09, 2017 temporal fascia medical animation gross anatomy of head and neck, dr g bhanu prakash duration. Hemimaxillectomy for desmoplastic ameloblastoma with immediate temporalis flap reconstruction this case was presented as an eposter presentation at the american association of oral and maxillofacial surgeons annual meeting in orlando, fl, usa, october 20, by chad n. Temporal muscle flap is especially easily predestinated for applying in reconstructive procedures of maxillafacial regions. A flap is a piece of tissue that is transferred from one part of the body to another with its blood supply preserved or immediately re. Temporalis muscle flap for the reconstruction oro facial defects case reportsoral sugery certified fixed orthodontic courses by indian dental academy 1. Pedicled temporalis muscle flap for craniofacial reconstruct.
Temporoparietal fascial flap was a viable option for subtle orbital and malar contour defects. Original article comparison of temporalis muscle fascia. A technique for onestage reconstruction for bony and soft tissue repair after subtotal bilateral maxillectomy is reported. Dec 11, 20 the temporalis flap in otolaryngology for more than 20 years, broadcastmed has been innovating digital strategies for healthcare organizations. Review committee for otolaryngology case log coding recommendations. The temporalis muscle flap can be designed to encompass various tissue types.
The temporalis muscle flap in reconstruction of intraoral. Original article comparison of temporalis muscle fascia and. Rearrange individual pages or entire files in the desired order. Both are described here, including their indications, anatomy, and flap harvesting technique, along with contraindications and potential complications. Temporal muscle flap in reconstruction of maxillofacial.
The anatomical basis for surgical preservation of temporal muscle. The temporalis muscle is classified as a type iii 2 muscle receiving its main vascular supply from the anterior and deep temporal arteries, branches from the second portion of the internal maxillary artery. The temporalis osteomyoperiosteal flap its blood supply and. The findings of this study showed that the temporalis superficial fascia flap is a good alternative as an interpositional material in treatment of temporomandibular joint ankylosis. Temporalis myofascial flap for primary cranial base. The study group comprised of 20 patients, both male and. Temporal muscle flap in reconstruction of maxillofacial tissues. Its values are axial vascularization, location close to reconstruction site, easy harvest and good results with its use. Like the tpff, the tmf is a reliable, myofascial flap that was also described more than a century ago. Jun 14, 2016 like the tpff, the tmf is a reliable, myofascial flap that was also described more than a century ago. The company was first in the world to broadcast live surgeries on the internet using its orlive solution which provides an intimate look inside the operating room. Temporalis myofascial flap transfer into the oral cavity without. Cadaver dissections, injection studies, and histological investigations were performed.
Anterior pericranial and galeofrontalispericranial flaps. A construct of fishhooks and rubber bands suspended from the leyla bar can facilitate retraction. In chronically inflamed wounds such as with osteoradionecrosis and orbitoantral fistula, tpff successfully restored vascularity, obliterated the defects, and. The temporalis system of flaps in head and neck reconstruction.
For more than a century, the temporalis muscle has been used for facial reconstructions. Pdf eyelid reconstruction following oncological resection remains a challenge. Reconstruction of temporomandibular joint ankylosis with temporalis myofascial flap in a cat. Facial reanimation with the temporalis transfer has withstood the test of time and still is a reference technique. Paresthesia or anesthesia of the temporal branch of facial nerve was absent in all cases. The authors divided the cases into two seriesbefore and after 1994because, after 1994, they started to perform free flap reconstructions, and indications for reconstruction with a temporalis muscle flap were changed results. The flap should be narrowed as one proceeds near the frontal branch of the facial nerve, so as not to transect the innervation to the muscles of the forehead.
Original article the application of reverse tubular medial. It is an axial flap based on the anterior and posterior deep temporal arteries. Review committee for otolaryngology case log coding. In 1898, the temporoparietal fascia flap was described nearly simultaneously for reconstruction of the external ear after a horse bite and for reconstruction of the lower eyelid. Ince the seminal description of the supraorbital crani otomy by jane, et al.
Efficacy of temporalis myofascial flap as an interpositional. Kim college of veterinary medicine, chonbuk national university, jeonju, republic of korea abstract. The temporalis muscle is found deep to the temporalis muscle fascia. Pdf temporalis myofascial flap for primary cranial base. Anatomy the temporalis muscle is a fanshaped muscle that originates from the temporalis fascia and from the temporal fossa. This versatile flap has been used as a pedicled, free, or composite flap with calvarium or hairbearing skin to reconstruct defects of the extremities, auricle, orbit, cheek, and oral cavity. A oneside pedicled temporalis osteomyoperiosteal flap is used for reconstruction of oral and nasal lining, maxillary bone, and oral, as well as nasal, soft tissue lining of the velum.
We report our results using the temporalis flap for palate reconstruction in one of. When the goal is to keep the subperiosteum intact, the surgeon may not be able to recognize the separate parts of the temporal muscle when it is mobilized. We report our results using the temporalis flap for palate reconstruction in one of the. Immediate reconstruction after ablative surgery in the midfacial region seems to be much more comfortable and functional. A wide variety of file folder with flap options are available to you, such as folder, bag, and wallet. Original article comparison of temporalis muscle fascia and fullthickness cartilage grafts in type 1 tympanoplasty yakup yegi.
The temporal muscle fascia lies deep to the tpf over the temporalis muscle. Smith, md, yadranko ducic, md, frcsc, facs, and robert adelson, md, dallas and fort worth, texas objective. The pterional craniotomy as described previously by the first author requires creation of a special flap over the temporalis muscle for increased visibility. A wide variety of flap file options are available to you, such as folder, bag, and wallet. Clinical articel efficacy of temporalis myofascial flap as an interpositional graft material in the management of tmj ankylosis. Hemimaxillectomy for desmoplastic ameloblastoma with. Smith, md,1,2 yadranko ducic, md, frcsc,1,2,3 robert t. The temporalis muscle flap for palate reconstruction. Temporalis muscle flap vula university of cape town. The advantage of the temporalis muscle flap is the ease of access to the muscle, the moderate quantity of muscle that can be harvested, and the ability to transfer the muscle to the oral cavity.
In a few weeks, good results can be obtained with a single and rather simple surgical procedure. Once the coronal flap is raised, the pericranial flap is elevated off of the calvarium down to approximately 1 cm above the supraorbital rims. Andersen 8 was the first to describe the technique and its results. The temporalis muscle flap in contemporary oral and maxillofacial surgery article in oral and maxillofacial surgery clinics of north america 154. The flap adds protection and security and allows you to take your files wherever you go. The temporalis muscle flap is accessed through a pretragal incision, which extends superiorly into. The advantage of the temporalis muscle flap is the ease of access to the muscle, the moderate quantity of muscle that can be harvested, and the ability.
Available in a variety of sizes, pockets, closures, materials, expansions, and with preprinted and customizable tabs. The temporalis flap remains as one of the reconstructive options for patients with facial paralysis. Discover a revolutionary approach to reconstructive surgery. Temporalis muscle flap for the reconstruction oro facial. It provides a thin sheet of vascularized fascia based on the superficial temporal artery and vein.
Temporalis muscle flap and temporoparietal fascia flap. There were no signs of reankylosing in any of the patients. The pericranial flap is reflected forward and covered with a wet lap sponge until it is needed. Doppler ultrasonography should be used preoperatively to determine the reliability of the superficial temporal artery and to map the course of the main pedicle, frontal branch, and parietal branch. Immediate reconstruction after ablative surgery in the mid facial region seems to be much more comfortable and functional. The temporal muscle, also known as the temporalis, is one of the muscles of mastication. Reconstruction of maxillectomy and midfacial defects. The alt flap in particular has been used with great success for facial contour reconstruction 46,23. You can also choose from elastic closure folder, presentation folder, and clip file flap file, as well as from pp, paper, and leather flap file there are 1,012 suppliers who. In these cases, the muscle may be employed to restore dynamic function to the paralyzed face.
The versatility of temporalis muscle flap in reconstruction. Scalp elevation separate from the underlying temporalis fascia should be minimized to prevent creation of an anatomical. The alt is a fasciocutaneous flap, which can easily be sculpted even among patients with high bmi to conform to a defect it can be folded on itself among patients with low bmi and can be. Dale browne, md, at wake forest baptist health, performs a temporalis flap procedure. More recently, a split temporalis muscle flap elevated on the superficial temporal pedicle has been described, for which the resulting gain of length makes crossing of the midline possible, as well as reconstruction of substance losses exceeding the midline. Both deep temporal arteries have a mean vessel diameter of 1 mm. The scalp flap is partially elevated anteriorly from the underlying superficial temporalis fascia with blunt and sharp dissection. Reconstruction of temporomandibular joint ankylosis with. Original article simultaneous anterolateral thigh flap and. The temporalis muscle flap johan fagan the temporalis muscle flap comprises the temporalis muscle, with or without the overlying temporalis fascia. The aims of this paper are to document the utility of and our outcomes with.
Jul 06, 2012 temporal muscle flap is especially easily predestinated for applying in reconstructive procedures of maxillafacial regions. Both are described here, including their indications, anatomy, and flapharvesting technique, along with contraindications and potential complications. Hairbearing temporoparietal fascial flap reconstruction. The temporalis muscle flap for intraoral reconstruction jama. There is a loose, areolar plane over the skull and temporalis muscle fascia that allows the flap to be raised from the deep fascia quite easily. Shindo has been using these advanced microsurgical approaches with considerable success. This is in contrast to a graft where the tissue is detached and relies on nourishment from the.
Care must be taken not to disrupt the deep branches of the supraorbital and supratrochlear vessels. Despite these descriptions of its use in head and neck reconstruction, the flap remained an obscure and underused tool until an explosion of new descriptions of it. Efficacy of temporalis myofascial flap as an interpositional graft material in the management of tmj ankylosis. Temporalis muscle flap was first used by golovine more than one hundred years ago and still it is very reliable regional myofascial flap for the reconstruction of the maxillofacial defects after.
Temporalis myofascial flap tmf and immediate soft tissue. The temporalis flap in otolaryngology for more than 20 years, broadcastmed has been innovating digital strategies for healthcare organizations. The versatility of temporalis muscle flap in reconstruction of maxillofacial region anastasia dessy harsono, prasetyanugraheni kreshanti, siti handayani, kristaninta bangun jakarta, indonesia latar belakang. The temporoparietal fascia tpf is an extension of the subcutaneous musculoaponeurotic system smas inferiorly and the galea aponeurotica superiorly. In the series after 1994, flaps were most commonly used for reconstruction of. Bhanu prakash usmle, fmge and neet pg 16,856 views. Pdf temporalis muscle flap in midfacial reconstruction. Its attachment to the muscle is preserved and it is not raised with the skin flap as. Anterior craniofacial resection with formal anterior bifrontal craniotomy.
Preservation of the frontotemporal branch of the facial. The utility of the temporalis muscle flap for oropharyngeal, base of. Multiple techniques have been described for isolated upper or. Two of these, the temporoparietal tp fascia and temporalis flaps, are most commonly used for reconstructing defects in the head and neck because of their proximity, reliability, and adaptability. Keep your desk, work surface or countertop organized with a smead expanding file. Temporalis myofascial flap for primary cranial base reconstruction after tumor resection article pdf available in skull base surgery 184. The temporalis muscle flap is far less bulky, more pliable, nonhair bearing, and in closer proximity to the oral cavity. Case report treating of old dislocation of mandibular. Original article temporalis muscle flap for reconstruction of skull base defects jesse e. The temporalis muscle flap is a reliable, nonbulky, myofascial flap that has been used for closure of a variety of defects as well as reconstruction both of medium and large areas of the maxillofacial region.
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