The utility of the temporalis muscle flap for oropharyngeal, base of tongue, and nasopharyngeal reconstruction

Abstract

OBJECTIVE: To determine the efficacy of temporalis muscle flap reconstruction of various defects of the oropharynx, nasopharynx, and base of tongue. STUDY DESIGN: Retrospective chart review of a consecutive series of 24 patients who underwent a total of 26 temporalis flaps (2 bilateral) by the senior author (Y.D.) from September 1997 to August 2003 for reconstruction of defects of the oropharynx, nasopharynx, and base of tongue. METHODS: Variables and outcomes that were examined included defect location, size, adjunctive therapy, complications, and ability to tolerate oral intake at follow-up. RESULTS: There was no evidence of flap failure in our series of patients. There were 2 cases of minor flap loss related to early prosthetic rehabilitation. Two cases of transient frontal nerve paralysis were noted. A 30.8% rate of complication (all minor) was noted in this study. At a mean follow-up of 12 months, 54.2% of patients were tolerating a full diet, 37.5% were tolerating most of their nutrition by mouth, and 8.3% were g-tube dependent. CONCLUSION: The temporalis muscle flap represents an excellent alternative in reconstruction of otherwise difficult-to-reconstruct defects of the nasopharynx, oropharynx, and base of tongue. Donor site aesthetics are well accepted by patients with primary hydroxyapatite cement cranioplasty with or without secondary lipotransfer.