ELIMINATION OF MAXILLARY DEFECTS USING TEMPORAL MUSCLE

Objective. To analyze the effectiveness of methods for anaplerosis of maxillary defects resulting from congenital pathologies and oncological maxillectomy, as well as to develope indications for the applied technique. Material and methods. 15 patients with defects of the upper jaw and hard palate were treated (9 men and 6 women). Among them there were 10 cases of cleft palate and 5 cases of subtotal maxillary defects. The method involved relocation of the temporal muscle only, the entire muscle, or part thereof. The transantral and direct relocation was used. Results. We noticed complete insertion of muscle to the boundaries of the defect and further complete epithelialization in 13 of 15 operated patients. In the postoperative period, the flap in the oral cavity does not require any special treatment due to the fact that the muscle is protected by its fascia on one side and by periosteum on the other. After 4-6 weeks, a muscle epithelial-ization occurs, and soft tissues that fill the defect are almost no different from those around them. The histologic examination of tissues revealed that the surface is a non-keratinized stratified squamous epithelium, which confirms the influx of the mucosa on the flap surface from the defect boundaries and complete epithelialization of the muscle surface. Conclusion. Application of the described method allows to close the maxillary defects and to obtain a mucous cover. In our view, the use of temporal muscle in some cases is the optimal method of choice to eliminate maxillary defects and defects of the hard palate.

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