The temporalis muscle flap for head and neck reconstruction.

The temporalis muscle receives its blood supply from the anterior and posterior deep temporal arteries. These run between the muscle and the periosteum and, therefore, subperiosteal elevation of this fan-shaped muscle from its origin in the temporal fossa results in a viable muscle flap whose arc of rotation and reach can be increased by resection of the zygomatic arch and the coronoid process of the mandible. The flap is useful in reconstruction of the mouth where it reaches at least to the ipsilateral lower canine tooth, the palate to the midline, the orbit and the ear. Skin grafts are readily accepted on its surface. The surgical technique is described in detail and the use of the flap in two representative cases is documented.