Temporalis muscle flap in the reconstruction of a maxillary defect caused by exeresis of ameloblastic carcinoma

Authors

Keywords:

ameloblastic carcinoma, odontogenic neoplasms, temporalis muscle flap, maxillary reconstruction.

Abstract

Introduction: Ameloblastic carcinoma is a rare condition emerging as a primary neoplasm or from a preexisting ameloblastoma. Temporalis muscle flap is a therapeutic option frequently used for reconstruction of the defect resulting from surgical exeresis. Objective: Present a clinical case of esthetic and functional restoration by reconstruction with temporalis muscle flap of a maxillary defect caused by exeresis of an ameloblastic carcinoma. The case is presented because of the infrequent occurrence of this condition. Clinical case: A female 49-year-old patient reports "a lump" in her palate of nine months evolution. Physical examination finds an increase in volume in the left infraorbital region. Computed axial tomography was indicated, which revealed the presence of a hyperdense image in the left maxillary sinus with internal calcification causing lysis of the nasal bone and the zygomatic bone, and infiltrating soft tissue. A sample was taken for biopsy, which reported a tumor with a high degree of malignancy corresponding to ameloblastic carcinoma. Chest radiography did not show the presence of lung metastasis. Infra- and mesostructure maxillectomy was performed, the lesion was removed with a surgical safety margin, and the palatine defect was reconstructed with a pediculated temporalis muscle flap. Chemo- and radiotherapy were indicated as adjuvants to the surgical treatment. Postoperative follow-up found good clinical evolution and secondary epithelization of the temporalis muscle in the palatine area with restoration of functions. Conclusions: A clinical case was presented of ameloblastic carcinoma, a condition with a low frequency of occurrence. Surgery was the basic component of the treatment applied. Once surgical resection was performed, the palatine defect was reconstructed by means of a temporalis muscle flap, a useful option to achieve the restoration of esthetic and biological functions, such as swallowing and speech.

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Author Biographies

Juan Guillermo Sánchez Acuña, Universidad de Ciencias Médicas de La Habana, Facultad de Estomatología "Raúl González Sánchez". La Habana

Especialista de 2do Grado en Cirugía Maxilofacial. Diplomado de Cabeza y Cuello. Máster en Salud Bucal Comunitaria. Profesor Auxiliar

Denia Morales Navarro, Universidad de Ciencias Médicas de La Habana, Facultad de Estomatología "Raúl González Sánchez". La Habana

Doctora en Ciencias Estomatológicas. Profesora Titular.

Orlando Hernández Feria, Universidad de Ciencias Médicas de La Habana, Facultad de Estomatología "Raúl González Sánchez". La Habana

Especialista de I grado en Estomatología General Integral. Residente de 2do año de Cirugía Maxilofacial. Profesor Instructor.

Published

2019-10-14

How to Cite

1.
Sánchez Acuña JG, Morales Navarro D, Hernández Feria O. Temporalis muscle flap in the reconstruction of a maxillary defect caused by exeresis of ameloblastic carcinoma. Rev Cubana Estomatol [Internet]. 2019 Oct. 14 [cited 2025 Feb. 4];56(4):1-10. Available from: https://revestomatologia.sld.cu/index.php/est/article/view/2108

Issue

Section

Case Report

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