title: New method for maximum mobilization of temporalis muscle flap.
abstract: BACKGROUND
  Pedicled temporalis muscle flap presenting a good flap for closing large craniofacial defects. Careful surgeons usually do not mobilize temporalis muscle flap enough to make appropriate use, fully closure, especially if defect exceeds the median line.
  
  
  METHODS
  Temporalis flap was used in 16 patients, ages ranged between 12 and 76. In all cases defect reconstruction was done by useing new method of extending standard temporal muscle flap. During surgical procedure it is very important to keep periosteal elevator in close contact with the bone. Then, there is no risk for pedicle injury. After vascular pedicle is identified elevating temporal muscle has to be continued by releasing the muscle insertion from the coronoid process. By this way, flap length and arc of rotation is increased.
  
  
  RESULTS
  The flap remained viable in all instances. Most of the patients experienced no perioperative complications. There was no major complications or mortality as a result of performed procedures.
  
  
  CONCLUSIONS
  With this division, flap length was increased at least 2 cm wich is enough for covering defects crossing the midline. Instead of using bilateral temporalis muscle flaps for defect closure, unilateral is sufficient. With this extension of the pedicle length now rotation point is not at the level of the zygomatic arch but lower part mandibular neck.
authors.affiliation: Clinic of Maxillofacial surgery, Clinical center of University of Sarajevo. Bosnia and Herzegovina.
authors.forename: Tarik
authors.initials: T
authors.lastname: Masic
authors.forename: Emina
authors.initials: E
authors.lastname: Babajic
authors.forename: Almir
authors.initials: A
authors.lastname: Dervisevic
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Hassouba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps; D055815:Young Adult