Scalp reconstruction using the reverse temporalis muscle flap: a case report

Abstract

The scalp is the thickest skin in the body and protects the intracranial structures. The coverage of a large scalp defect is a difficult surgical procedure, the full details of which must be considered prior to the procedure, such as defect size and depth, and various factors related to the patient's general condition. Although a free flap is the recommended surgical procedure to cover large scalp defects, it is a high-risk operation that is not appropriate for all patients. As such, other surgical options must be explored. We present the case of a patient with an ulcer on the scalp after wide excision and split-thickness skin graft for squamous cell cancer. We successfully performed a reverse temporalis muscle flap for this patient.

Keywords: Case reports; Reconstructive surgical procedures; Scalp; Ulcer.

Fig. 1

Preoperative photograph. Bone exposure is observed at the previous split-thickness skin graft site.

Fig. 2

Preoperative computed tomography images. Soft tissue defect and thinning parietal bone are seen on the left temporoparietal scalp. (A) Coronal and (B) Sagittal views.

Fig. 3

Schematic illustration of the reverse temporalis muscle flap.

Fig. 4

Postoperative photographs at 5 weeks (A) and at 2 months (B).