TEMPORAL MUSCLE FLAP AS A RECONSTRUCTIVE ALTERNATIVE IN PATIENTS WITH CONTRAINDICATIONS TO FREE MICROSURGERY: AN INTEGRATIVE LITERATURE REVIEW

Abstract

Reconstruction of maxillofacial defects after tumor resections represents a significant challenge in oral and maxillofacial surgery, especially in patients with contraindications to free microsurgery. In these cases, the temporalis muscle flap stands out as a reconstructive alternative due to its anatomical proximity, reliable vascularization, and lower surgical complexity. This study aimed to analyze the applicability of this technique in patients who are not candidates for microvascular reconstruction. The findings showed a high rate of tissue viability, good functional results in the separation between the oral and nasal cavities, improvement in speech and swallowing, and adequate coverage of defects involving the maxilla and palate. The main indications included elderly patients, those with significant systemic comorbidities, individuals with high anesthetic risk, and institutions with structural limitations for microsurgical procedures. The most frequently reported complications included aesthetic temporal depression, partial dehiscence, and transient limitation of mouth opening, generally managed conservatively. Despite volumetric limitations in extensive defects, the technique demonstrated predictable and satisfactory results in selected cases. In conclusion, the temporalis muscle flap remains a safe, effective, and current alternative, and should be considered a strategic option when free microsurgery is not feasible.