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Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy

BACKGROUND: Temporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporal...

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Autores principales: Aum, Jae Ho, Kang, Dong Hee, Oh, Sang Ah, Gu, Ja Hea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Plastic and Reconstructive Surgeons 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723994/
https://www.ncbi.nlm.nih.gov/pubmed/23898430
http://dx.doi.org/10.5999/aps.2013.40.4.348
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author Aum, Jae Ho
Kang, Dong Hee
Oh, Sang Ah
Gu, Ja Hea
author_facet Aum, Jae Ho
Kang, Dong Hee
Oh, Sang Ah
Gu, Ja Hea
author_sort Aum, Jae Ho
collection PubMed
description BACKGROUND: Temporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients. METHODS: Between August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs. RESULTS: The symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery. CONCLUSIONS: The orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique.
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spelling pubmed-37239942013-07-29 Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy Aum, Jae Ho Kang, Dong Hee Oh, Sang Ah Gu, Ja Hea Arch Plast Surg Original Article BACKGROUND: Temporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients. METHODS: Between August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs. RESULTS: The symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery. CONCLUSIONS: The orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique. The Korean Society of Plastic and Reconstructive Surgeons 2013-07 2013-07-17 /pmc/articles/PMC3723994/ /pubmed/23898430 http://dx.doi.org/10.5999/aps.2013.40.4.348 Text en Copyright © 2013 The Korean Society of Plastic and Reconstructive Surgeons http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Aum, Jae Ho
Kang, Dong Hee
Oh, Sang Ah
Gu, Ja Hea
Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy
title Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy
title_full Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy
title_fullStr Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy
title_full_unstemmed Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy
title_short Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy
title_sort orthodromic transfer of the temporalis muscle in incomplete facial nerve palsy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723994/
https://www.ncbi.nlm.nih.gov/pubmed/23898430
http://dx.doi.org/10.5999/aps.2013.40.4.348
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