A Single-Stage Reconstruction of Maxillectomy Defects with Temporalis Muscle Flap—Revisiting the Past

Oncological resections involving the maxillofacial unit are aggressive and functionally mutilating. The inherently complex maxillary defects pose a reconstructive challenge. The reconstructive options described vary from regional soft tissue to free or combinations of soft tissue flaps and alloplastic implants. The temporalis myofascial flap is a versatile flap for reconstruction of maxillofacial defects. Due to its robust vascularity, adequate bulk, proximity to the defects, and minimal donor-site morbidity, it remains a popular choice of reconstruction for a contemporary surgeon. A retrospective analysis of nine patients undergoing a single-stage temporalis myofascial flap reconstruction following maxillectomy was performed to determine its utility, post-operative complications, and its impact on quality of life. The patients undergoing surgery had tumours involving maxillary alveolar–buccal complex (four), maxillary antrum (three), and hard palate (two). The histological types of the tumour were squamous cell carcinoma (six), adenocarcinoma (one), adenoid cystic carcinoma (one), and undifferentiated pleomorphic sarcoma (one). Post-surgical defects reconstructed with this flap included infrastructure maxillectomy (one), subtotal maxillectomy (one), total maxillectomy (five), and extended total maxillectomy (two). None of the flaps failed in any patient (flap survival rate of 100%); one patient had minimal dehiscence which was managed conservatively. No significant speech and swallowing-related issues were reported by any of the patients. Aesthetic expectations were met in most of the patients.