The inferiorly based masseter muscle flap: anatomical basis for its use in head and neck reconstructive surgery.

The aim of this study was to investigate and elucidate the anatomical basis for the use of the inferiorly based masseter muscle flap in the reconstruction of oropharyngeal defects after ablative surgery. The anatomy of the masseter muscle, with particular emphasis on its blood supply, was studied using plain and coloured resin injected dissections and a series of digital subtraction angiograms and external carotid arteriograms. Both techniques were demonstrated to be reliable and effective means of anatomical investigation of blood vessels. The vascular anatomy of the masseter muscle and the anatomical and angiological results as well as a case report are described. The masseter muscle, when used as an inferiorly based flap, provides the necessary bulk for reconstruction of moderate size defects in the lateral border of the tongue, posterior floor of the mouth, retromolar trigone, anterior tonsillar pillars and lateral pharyngeal wall. Although the masseter muscle has small dimensions, it offers a reliable method of reconstruction in selected defects without the disadvantages of cosmetic and functional loss.