title: Functional outcomes and suitability of the temporalis myofascial flap for palatal and maxillary reconstruction after oncologic resection.
abstract: OBJECTIVE
  The temporalis myofascial flap (TMF) is a method of palatal reconstruction that offers a single-stage, reliable, and functional technique to repair oncologic defects involving the oral cavity following tumor removal. It is hypothesized that both speech and swallowing function are preserved following TMF.
  
  
  METHODS
  In a retrospective and prospective case series, this study evaluated the surgical outcomes of 72 patients undergoing surgical resection and reconstruction of the hard and soft palate using a TMF. Of this series, 25 patients underwent nasalence and swallowing quality-of-life testing to determine speech and swallowing function following this procedure.
  
  
  METHODS
  Reliability, safety, and effectiveness data endpoints on TMF reconstruction were collected and analyzed. Instrumental measures of nasalence (KayPentax Nasometer, Lincoln Park, NJ) and swallowing quality of life measures (MD Anderson Dysphagia Inventory [MDADI] were acquired.
  
  
  RESULTS
  All TMF's were successfully transferred with complete healing of the oncologic defect. The group mean nasalence for connected speech tasks were within normal limits for connected speech--high- and low-pressure tasks (M = 21% and M = 17%). The group mean nasalence scores for sustained vowels were mildly affected (M = 26%). The group mean MDADI score was 79 (SD = 16), indicating good to mildly affected swallowing quality of life. Neither nasalence nor MDADI scores appeared to vary as a function of defect region.
  
  
  CONCLUSIONS
  The TMF is an oncologically safe and effective method of palate reconstruction that affords excellent quality of life to appropriately selected patients without reliance on other reconstructive techniques.
authors.affiliation: Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. jdbrowne@wfubmc.edu
authors.forename: J Dale
authors.initials: JD
authors.lastname: Browne
authors.forename: Susan
authors.initials: S
authors.lastname: Butler
authors.forename: Catherine
authors.initials: C
authors.lastname: Rees
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000601:surgery*; D008875:Middle Aged; D010157:Palatal Neoplasms / Q000601:surgery*; D021362:Palate, Hard / Q000601:surgery; D011788:Quality of Life; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome