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.
About the authorsNazaryan David Nazaretovich
Clauser L., Curioni C., Spanio S. The use of the temporalis muscle flap in facial and craniofacial reconstructive surgery. A review of 182 cases. J. Craniomaxfac. Surg. 1995; 23 (4): 203-14. DOI: 10.1016/S1010-5182(05)80209-4
Krzymanski G., D^browski J., Przybysz J., Domanski W., Biernacka B., Pi§tka T. Temporal muscle flap in reconstruction of maxillo-facial tissues. Contemp. Oncol. (Pozn.) 2012; 16 (3): 244-9. DOI: 10.5114/wo.2012.29293
Demas P.N., Sotereanos G.C. Transmaxillary temporalis transfer for reconstruction of a large palatal defect: report of a case. J. Oral Maxillofac. Surg. 1989; 47 (2): 197-202. DOI: 10.1016/S0278-2391(89)80119-3
Van der Wal K.G., Mulder J.W. The temporal muscle flap for closure of large palatal defects in CLP patients. Int. J. Oral Maxillofac. Surg. 1992; 21 (1): 3-5.
Неробеев А.И., Плотникова Н.А. (ред.) Восстановительная хирургия мягких тканей челюстно-лицевой области. М.: Медицина; 1997: 51-4. [Nerobeev A.I., Plotnikova N.A. (Eds.) Reconstructive surgery of the soft tissues of maxillofacial region. Moscow: Meditsina; 1997: 51-4 (in Russ.).]
Eldaly A., Magdy E.A., Nour Y.A., Gaafar A.H. Temporalis myofascial flap for primary cranial base reconstruction after tumor resection. Skull Base. 2008; 18 (4): 253-63. DOI: 10.1055/s-2007-1016958
De Cevallos J.G., Carretero J.L., de Vera J.L., Garcia M.B. Le Fort I approach for midline tumors of the palate. Craniomaxillofac. Trauma Reconstr. 2015; 8 (4): 348-51. DOI: 10.1055/s-0034-1399798
Baj A., Spotti S., Marelli S., Beltramini G., Gianni A. Use of porous polyethylene for correcting defects of temporal region following transposition of temporalis myofascial flap. ACTA Otorhinolaryngol. Ital. 2009; 29 (5): 265-9.
Jaiswal D., Yadav S.P., Shankhdhar V.K., Selva S.R. Chimeric superficial temporal artery based skin and temporal fascia flap plus temporalis muscle flap - an alternative to free flap for suprastructure maxillectomy with external skin defect. Indian J. Plast. Surg. 2011; 44 (3): 501-4. DOI: 10.4103/0970-0358.90
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