Deep Temporal Muscle Pedicled Flap: A Novel Reconstruction Technique Following Transorbital Approach, Anatomic Study, and Surgical Implications
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: The temporalis muscle flap has historically been used for repairing defects from orbital procedures and is commonly used in cranial, oral, and facial reconstructions. However, its application for reconstructing the skull base after a transorbital approach has not been explored. Reconstruction after a transorbital intradural approach is still object of preclinical and clinical investigation, with various techniques emerging recently. This study introduces a novel method suitable for extensive resections of the skull base, including intradural resections of the anterior, middle, and posterior cranial fossae.The study aimed to investigate the feasibility of rotating a vascularized myofascial flap from the anterior third of the temporalis muscle onto the skull base, exploring its extension into the middle cranial fossa after drilling the greater wing of the sphenoid. METHODS: Six endoscopic dissections were performed on formalin-fixed heads to illustrate the feasibility of preparing a deep fascia flap from the temporalis muscle. Red silicone latex was injected into the external carotid artery to confirm the vascular integrity of the deep temporal branches of the maxillary artery. RESULTS: The deep temporalis myofascial flap offers a large, well-vascularized tissue that can be easily rotated to cover skull base defects after transorbital approaches. Its coverage extends from the middle and anterior cranial fossae to the infratemporal fossa and the lateral wall of the cavernous sinus. It also effectively covers dural defects at the temporal pole. CONCLUSION: With an appropriate temporal bony window and sufficient exposure, it is feasible to endoscopically prepare a rotation flap from the anterior third of the temporalis muscle, minimizing the need for resecting the lateral orbital margin. This approach is a favorable alternative to traditional reconstruction techniques, offering quick setup in a single operative procedure. Future studies are needed to confirm minimal donor site morbidity regarding masticatory function.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".