Temporal Muscle Bipartition and Tripartition Transposition for Reconstructing the Orbital and Oral Empty Space in Mucormycosis of the Middle Third of the Face.

Background: Temporal muscle has great versatility to cover defects, caused by resections or large soft tissue losses of the middle facial third, has been used for more than 100 years. In the skin, the temporal muscle is transformed by the phenomenon called skin dermalization and mucolization in the oral cavity. Purpose: This article shows how the temporal muscle is divided into two segments (bipartition) or three segments (tripartition) achieving a transposition of the muscle to cover large empty spaces caused by orbital exenteration or in maxilectomy. In coronal slice tomography, we demonstrate the perfect adaptation of the temporal muscle to the periorbital soft tissues in 360 degrees of the orbital region. In the defect produced by the maxilectomy, a perfect seal is obtained to achieve the separation of the nasal cavity from the oral cavity.
Methods: The treatment was carried out in 3 immunocompromised adult patients, who presented mucormycosis of the middle third of the face and could not swallow or feed.
Results: The result we have in the survival of rhinocerebral mucormycosis is very high, due to extensive resections. Achieving that the patient has an adequate swallowing.
Conclusion: We consider that the treatment is excellent due to the proximity of the temporal muscle to the surgical defect, achieving the objective of reconstruction without rejection. © The Association of Oral and Maxillofacial Surgeons of India 2020.