Fig. 8

A 56-year-old man with recurrent palatal ACC underwent salvage surgery, including en bloc resection and reconstruction with an extended lower vertical trapezius island myocutaneous flap (TIMF). Computed tomography scan showing that the tumor invaded the middle cranial fossa and posterior cranial fossa (A). The patient underwent en bloc resection (B), and the extended lower vertical TIMF was harvested (C). The folded flap provided an inner and outer lining for repair of the through-and-through defect of the major craniomaxillofacial region (D, E)