Temporalis Fascia Flap for Temporomandibular Ankylosing Joint: Surgical Technique and Functional Outcomes

This book chapter presents a case report and discussion on the use of the temporalis fascia flap for the reconstruction of posttraumatic temporomandibular joint (TMJ) ankylosis. The chapter provides a detailed case presentation, operative procedure, and postoperative outcomes, along with a comprehensive discussion of the temporalis fascia flap technique.

The case presentation describes a patient with restricted mouth opening for 10 years due to left-sided TMJ ankylosis resulting from a fall and chin injury. Computed tomography with 3-D reconstruction confirmed the diagnosis. The operation involved temporalis fascia interposition arthroplasty, with a 1 cm condylectomy performed below the fused joint. The temporalis fascia flap was raised and transposed to fill the condylectomy gap. The postoperative period was uneventful, and satisfactory results were observed during follow-up examinations, with improved mouth opening.

The discussion section of the chapter introduces the temporalis fascia flap as a surgical technique commonly used in reconstructive procedures, especially in head and neck surgery. The technique involves utilizing the thin and pliable tissue of the temporalis fascia, which covers the temporalis muscle, to reconstruct defects in nearby areas. The advantages of the temporalis fascia flap, including its accessibility, thin and pliable nature, good blood supply, and minimal donor site morbidity, are discussed. The limitations, such as size and location constraints, limitations in tissue thickness, scar visibility, and potential complications, are also addressed.

In conclusion, this book chapter provides valuable insights into the use of the temporalis fascia flap for the reconstruction of posttraumatic TMJ ankylosis. Through the presentation of a case report, operative details, and a comprehensive discussion, the chapter highlights the efficacy and considerations of the temporalis fascia flap technique in achieving successful outcomes in reconstructive surgery