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Methods: A prospective pilot study was conducted on 12 patients to establish whether, under the difficult conditions prevailing in a developing country, the temporalis muscle flap is suitable as a safe and single-stage procedure for the repair of buccal defects combined with fibrous or osseous contractures of the temporomandibular joint., Results: The surgical procedures were performed from 1998 to 2000 in the Hôpital National du Niamey (Republic of Niger). Primary healing was achieved with all grafts. Local clinical and radiological follow-up (in Niger) was performed on seven patients after 12 and 24 months. Mouth opening of at least 1.5 cm was achieved in all cases, although there was virtually no use of physiotherapy to prevent scar contracture., Discussion: By contrast with expensive and surgically more complex reconstructions, our use of this procedure shows that even where medical conditions are less than ideal, a satisfactory functional and cosmetic result can be achieved in the long-term.