Temporalis Myofascial Flap in Orofacial Reconstruction: A Review and Experience of a Northern Nigerian Hospital

Abstract

Context: The Temporalis Myofascial Flap (TMF) is widely recognized for its high success rates in reconstructing oro-facial defects, offering advantages that overcome many limitations associated with other pedicled flaps.
Aim: To report the hospital’s experience with the use of TMF in oro-facial reconstruction.
Setting and Design: A retrospective study of patients who underwent cranio-maxillofacial soft tissue reconstruction using TMF at a tertiary hospital in Northwestern Nigeria between November 2018 and July 2023.

Materials and Methods: This descriptive retrospective cohort study utilized a self-designed proforma to extract data from patients’ medical records.
Statistical Analysis Used: Data were analyzed using IBM SPSS version 23. Statistical significance was set at p ≤ 0.05.

Results: Thirty-eight patients (20 males, 18 females), aged 6 to 60 years, were included. The TMF demonstrated notable versatility, as reflected in its wide range of indications (Table 1). All the flaps were inferiorly based and were successfully applied in 37 cases (97.4%). Complications occurred in 12 patients (31.4%) and included re-ankylosis deep to the TMF (n=1), transient pre-auricular swelling after ankylosis release (n=2), trismus (n=1), wound dehiscence following maxillectomy defect reconstruction (n=1), asymmetric infra-orbital contour after orbital floor reconstruction (n=2), and temporal hollowing (n=5, 13.2%). The occurrence of complications was significantly associated with the complexity of surgical reconstruction (Fisher’s exact test, p = 0.002) (Table 2).

Conclusion: The Temporalis Myofascial Flap remains a reliable and effective pedicled flap for oro-facial reconstruction, owing to its simplicity, versatility, favorable vascularity, and manageable complication profile. Its outcomes are comparable to those of other pedicled flaps and commonly used microvascular alternatives.