Management of the temporalis flap donor site

OBJECTIVE: To describe a technique of using a sterilized form of moldable cold cured acrylic, Cranioplastic, for camouflaging the depressed temporalis flap donor site, and to assess the long term morbidity and aesthetic results. METHODS: A retrospective clinical assessment of 50 consecutive patients who had temporalis myofascial flap surgery from 1988 to 1995. Any complications of healing, neurosensory deficit were recorded. The aesthetics of the temporal region was graded by subjective and objective methods. The histology of the tissues around the implant in one patient was examined under light microscopy. RESULTS: There was no major complications noted except immediate postoperative seroma formation and temporary paresis of the temporal branch of facial nerve. A satisfactory restoration of aesthetics at the temporal donor site was achieved with the moldable acrylic technique in 96% of patients. The capsular tissues surrounding the implanted acrylic consisted of hyalinized collagen fibres with scanty inflammatory cells. CONCLUSIONS: The use of moldable acrylic to restore the temporalis donor site is a simple, versatile and effective technique with minimal long term morbidity. The aesthetic result of the camouflage was satisfactory and the material exhibits good biocompability.