Chimeric Reverse Temporal Muscle and Pericranial Flap for Double Layer Closure of Deep Facial Defects

Publication date: Available online 24 May 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Said Algan, Onder Tan, Murat Kara, Akin Inaloz, Mehmet Akif Cakmak, Osman Enver Aydin
PurposeVolumetric or multi-planed defects of the upper and midface are still a challenge for reconstruction, because of limited regional flap options. In this study, we harvested the reverse temporalis muscle flap and pericranial flap based on the same vascular pedicle, superficial temporal artery (STA), in a chimeric manner to obtain a double layer closure of deep facial defects.MethodsThis study was a prospective case series which was performed in Department of Plastic Surgery, in Ataturk University. The outcomes including flap survival, postoperative complications, reconstructive success, aesthetic view and donor site morbidity were evaluated clinically.Results14 patients (10 males and 4 females) with deep defects on middle third of the face were reconstructed using chimeric reverse temporal muscle and pericranial (RTMP) flap. All chimeric RTMP flaps survived completely without postoperative complications. All defects were successfully obliterated and covered with chimeric RTMP flaps. The patients were satisfied with the aesthetic results.ConclusionThe chimeric RTMP flap can be safely used in moderate to large sized three dimensional defects of the middle and upper face, as a good reconstructive option. Both smooth and durable coverage over the bulky muscle flap which was used to fill the volume defect, and increase in the amount of flap for larger volume defects can be obtained by means of the pericranial segment of the chimeric RTMP flap.



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