The use of temporalis myofascial flap (TMF) as a pedicled flap in craniofacial reconstructive surgery is well established. This technique may provide a cosmetic deformity of the temporal fossa with an asymmetric contour of the head. Reconstruction of this donor site deformity is desirable. We report the use of polymethyl-methacrylate (PMMA) (Palacos ®). From January 2009 to December 2011, 11 patients (6 men and 5 women) aged 81 to 56 years (mean 67) were treated. Ten patients had squamous cell carcinoma and 1 mucoepidermoid carcinoma of minor salivary glands in the upper jaw. The oncological defects were reconstructed with TMF and the temporal fossa was simultaneously filled with PMMA. A retrospective review of the postoperative complications (hematoma, seroma) and the aesthetical results was conducted. All patients were contacted 6 months later by phone and provided with information pertaining to the aims of this study. The patients were then instructed on how to fill out the relevant questionnaires. Aesthetic results were judged satisfactory from all patients. The hemicoronal skin flap healed uneventfully in all patients and did not cause a visible scar even to bald male patients. In our group of patients no surgical seroma or hematoma in temporal fossa were observed. PMMA reconstruction was characterized by excellent biocompatibility with no inflammatory activation. The symmetry of temporal fossa was judged satisfactory. Intraoperative cast-molded camouflage of the temporalis flap donor site with PMMA is a feasible, accurate, fast, and cost-efficient technique that results in excellent cosmetic.

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