Acta Anatomica Sinica ›› 2020, Vol. 51 ›› Issue (5): 659-663.doi: 10.16098/j.issn.0529-1356.2020.05.004

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Anatomy of transposition of the temporalis muscle flap for skull base reconstruction

LIU Quan SUN Xi-cai WANG Huan ZHANG Huan-kang YU Hong-meng* WANG De-hui*#br#   

  1. Department of Otolaryngology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China
  • Received:2020-04-07 Revised:2020-05-22 Online:2020-10-06 Published:2020-10-06
  • Contact: YU Hong-meng;WANG De-hui E-mail:wangdehuient@sina.com

Abstract:

Objective To investigate surgical anatomy of transposition of the temporalis muscle flap(TMF) for skull base reconstruction.  
 Methods The dissection of the temporalis muscle flap was performed on six fresh cadaver heads (12 sides). The temporalis muscle was harvested through a traditional open approach. The length and width of the temporalis muscle flap were measured and the arterial supply of the temporalis muscle flap was also exposed. The temporalis muscle flap was transposed into the maxillary sinus and nasal cavity through the infratemporal fossa by an endoscopic transnasal transmaxillary approach. The simulate operation that the temporalis muscle flap was used to reconstruct the skull base defects was performed on six fresh cadaver heads.  Results The length of the temporalis muscle flap harvested from temporal line to the tip of the coronoid process of the mandible was (11.7±0.7)cm. Maximum width of the flap was (9.2±0.8)cm. The temporalis muscle flap could reconstruct the defects of cranial skull base, sellar and clivus.   Conclusion Transposition of the temporalis muscle flap via the infratemporal fossa is an alternative and effective method  for reconstruct the skull base after the endoscopic surgery.

Key words:  Temporalis muscle flap, Skull base, Infratemporal fossa, Endoscopy, Human

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