El colgajo de músculo temporal en la cirugía de la ATM: ¿Sigue siendo una opción válida?

Abstract

The temporalis muscle has been used in craniofacial reconstruction for more than 130 years. In TMJ surgery, it has been used fundamentally in two entities: TMJ ankylosis and as a post-discectomy joint disc replacement. The objective of this review is to assess whether the temporalis muscle flap continues to have an indication in TMJ surgery, or whether there are more appropriate alternatives for these entities. To do this, a narrative review is carried out on the use of the temporalis muscle flap in TMJ surgery based on the articles that refer to its use individually or in comparison with other techniques. We make a description of the surgical technique and its main changes over the years. In ankylosis surgery, the treatment seeks to eliminate the ankylotic part, restore joint function and, above all, prevent re-ankylosis. The use of the temporalis muscle, as an interposition material, has been shown to reduce the incidence of re-ankylosis, but its complications have led to the search for alternatives. In surgery for internal derangement, its use as a disc replacement began in the 1990s but given the current controversy as to whether it is necessary to replace the disc when performing a discectomy, the possible theoretical advantages of this flap don ́t compensate its complications. In conclusion, this technique, in TMJ surgery, has alternatives with better results, which means that it is no longer the first choice.