Endoscopic Harvest of a Temporalis Flap for a Maxillary Reconstruction

Arribas-García, Ignacio; Alcalá-Galiano, Andrea

doi:10.1097/scs.0b013e3181abb234

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…In terms of the skull base reconstruction, the temporalis muscle flap has the ability to meet the needs of type III and type IV TEN. The temporalis muscle flap has become extensively used in tissue reconstruction of the skull base, maxillofacial, oral cavity, and oropharyngeal defects after open oncological procedures since its first use in reconstructing the orbit after an exenteration of the eye by Golovine in 1898 ( 20 , 21 ). In this study, the temporalis muscle flap was used for six patients, including two type III and four type IV.…”

Section: Discussionmentioning

confidence: 99%

Types of Transnasal Endoscopic Nasopharyngectomy for Recurrent Nasopharyngeal Carcinoma: Shanghai EENT Hospital Experience

Liu

Sun

et al. 2021

Front. Oncol.

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BackgroundTransnasal endoscopic nasopharyngectomy (TEN) has become increasingly used for recurrent nasopharyngeal carcinoma (rNPC); however, there is no report on the definitive resectable contour for TEN according to the latest staging system for nasopharyngeal carcinoma. The aim of this study was to establish the types of TEN for rNPC.Materials and MethodsA total of 101 rNPC patients underwent TEN from January 2016 to April 2019 at the authors’ institution. TEN was categorized into four types, which included type I (n=40) with resection of the nasopharynx and sinuses; type II (n=10) with lateral extension to the parapharyngeal space; type III (n=40) with lateral extension to the floor of the middle cranial fossa and the infratemporal fossa and superior extension to the orbital apex and the cavernous sinus back to the prevertebral region; and type IV (n=11) with the resection of the involved internal carotid artery following type III. The 2-year overall survival rate (OS) and local recurrence-free survival rate (LRFS) were assessed.ResultsThe median time of follow-up was 20 months. Twenty-five patients reoccurred. Nineteen patients died. Independent predictors of outcome on multivariate analysis were recurrent T stage (P = 0.039), types of TEN (P = 0.002) and surgical margin (P = 0.003). The 2-year OS and LRFS was 76.2% and 53.6%, respectively.ConclusionsThe result of TEN in the treatment of rNPC is promising. The types of TEN will provide effective guideline for surgical treatment of rNPC.

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Section: Discussionmentioning

confidence: 99%

Types of Transnasal Endoscopic Nasopharyngectomy for Recurrent Nasopharyngeal Carcinoma: Shanghai EENT Hospital Experience

Liu

Sun

et al. 2021

Front. Oncol.

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“…In 2009, the first case of maxillary reconstruction with TMF harvested by an endoscopic procedure was reported by Arribas-Garcia and Alcalá-Galiano. 7 However, the acquisition of TMF often requires scalp incision, which can affect aesthetics. Other common complications include paralysis of the frontal and temporal branches of the facial nerve, trismus, and temporal fossa defects.…”

Section: Introductionmentioning

confidence: 99%

Transinfratemporal Fossa Transposition of the Temporalis Muscle Flap for Skull Base Reconstruction after Endoscopic Expanded Nasopharyngectomy: Anatomical Study and Clinical Application

Sun

Liu

et al. 2021

J Neurol Surg B Skull Base

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Background Temporalis muscle flap (TMF) is widely used in traditional skull base surgery, but its application in endoscopic skull base surgery remains rarely reported. We aimed to investigate the surgical anatomy and clinical application of TMF for reconstruction of skull base defects after expanded endoscopic nasopharyngectomy. Materials and Methods Nine fresh cadaver heads (18 sides) were used for endoscopic dissection at the University of Pittsburgh School of Medicine in the United States. TMF was harvested using a traditional open approach and then transposed into the maxillary sinus and nasal cavity through the infratemporal fossa using an endoscopic transnasal transmaxillary approach. TMF length was then measured. Moreover, TMF was used for the reconstruction of skull base defects of six patients with recurrent nasopharyngeal carcinoma after expanded endoscopic nasopharyngectomy. Results The length of TMF harvested from the temporal line to the tip of the coronoid process of the mandible was 11.8 ± 0.9 cm. The widest part of the flap was 9.0 ± 0.4 cm. When TMF was dislocated from the coronoid process of the mandible, approximately another 2 cm of reach could be obtained. When the superficial layer of the temporalis muscle was split from the deep layer, the pedicle length could be extended 1.9 ± 0.2 cm. TMF could cover skull base defects in the anterior skull base, sellar, and clivus regions. Conclusion TMF can be used to reconstruct skull base defects after endoscopic expanded nasopharyngectomy and can effectively prevent the occurrence of serious complications in patients with recurrent nasopharyngeal carcinoma.

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Evidence for the Functional Compartmentalization of the Temporalis Muscle: A 3-Dimensional Study of Innervation

Chang

Cantelmi

Wisco

et al. 2013

Journal of Oral and Maxillofacial Surgery

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Endoscopic Harvest of a Temporalis Flap for a Maxillary Reconstruction

Cited by 5 publications

References 21 publications

Types of Transnasal Endoscopic Nasopharyngectomy for Recurrent Nasopharyngeal Carcinoma: Shanghai EENT Hospital Experience

Types of Transnasal Endoscopic Nasopharyngectomy for Recurrent Nasopharyngeal Carcinoma: Shanghai EENT Hospital Experience

Transinfratemporal Fossa Transposition of the Temporalis Muscle Flap for Skull Base Reconstruction after Endoscopic Expanded Nasopharyngectomy: Anatomical Study and Clinical Application

Evidence for the Functional Compartmentalization of the Temporalis Muscle: A 3-Dimensional Study of Innervation

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