Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction

Orbital floor defects may result from maxillary trauma or tumor resection. Traditional reconstruction techniques often rely on vascularized or non-vascularized free bone grafts, which carry risks of graft failure due to thrombosis, infection, or poor integration. This protocol introduces a novel technique using a coronoid-temporalis pedicled flap (CTPF) for repairing small-to-medium orbital floor defects. The protocol involves harvesting the coronoid process with its attached temporalis muscle pedicle, transposing the flap to the orbital floor, contouring the bone to fit the defect, and achieving rigid fixation. When soft tissue coverage is insufficient, additional options such as local advancement or free flaps can be employed. The CTPF technique offers a biomechanically stable, vascularized solution that avoids the complications associated with microvascular anastomosis. It is particularly suitable for moderate defects, though it may not provide sufficient volume for large or complex orbital reconstructions. A representative clinical case illustrates the technical feasibility of this approach and demonstrates anatomic restoration with preservation of facial contour. While quantitative outcomes are not reported, the procedure shows potential as a viable alternative to conventional bone grafts or alloplastic implants.