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Temporalis tendon transfer

Peter J Ciolek, Brandon L Prendes, Michael A Fritz
INTRODUCTION: The reconstructive goals following radical parotidectomy include restoration of symmetry, reanimation of the face, and reestablishment of oral competence. We present our experience utilizing the anterolateral thigh (ALT) free flap, orthodromic temporalis tendon transfer (OTTT), and facial nerve cable grafting to reestablish form and function. MATERIAL AND METHODS: From 2010 to 2016, 17 patients underwent radical parotidectomy followed by immediate reconstruction...
June 7, 2018: American Journal of Otolaryngology
Michal Brichacek, Babar Sultan, Kofi D Boahene, Lisa Ishii, Patrick J Byrne
OBJECTIVES: We describe an approach to reanimation of complete, prolonged facial paralysis using minimally invasive temporalis tendon transfer (MIT3) by the melolabial or transoral approach. Objective outcome measures are evaluated based on symmetry, and grading of preoperative/post-operative results and the scar at the melolabial fold. STUDY DESIGN: Retrospective cohort study. METHODS: Twenty-five patients undergoing the MIT3 technique were studied...
August 2017: Plastic Surgery
Thomas Edward Pidgeon, Radovan Boca, Fazel Fatah
BACKGROUND: This report describes the results of a surgical procedure for facial reanimation. This single-stage technique involves the orthodromic transfer of only a superficial segment of the temporalis tendon. This is extended with fascia lata to achieve elevation of the oral commissure along the desired vector in the paralysed hemi-face. METHODS: A retrospective case note review was performed. Patients' photographs were objectively evaluated with Facial Assessment by Computer Evaluation (FACE) software...
March 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Alexandra E Kejner, Eben L Rosenthal
OBJECTIVES/HYPOTHESIS: Evaluate outcomes of the standard static sling and orthodromic temporalis tendon transfer reanimation for facial nerve paralysis. STUDY DESIGN: Retrospective case series at a tertiary care hospital of head and neck cancer patients with facial nerve palsy secondary to malignancy or resection. METHODS: From 2004 to 2014, patients undergoing resection of malignancy that involved facial nerve palsy requiring facial reanimation were identified...
September 2016: Laryngoscope
Sung Yul Ahn, Hyang Joon Park, Jong Pill Kim, Tae Hwan Park
Facial paralysis resulting from leprosy has a serious impact on the entire face especially in the areas innervated by the facial nerves. In particular, lagophthalmos in patients with leprosy causes exposure keratitis, corneal, and conjunctival dryness, which can progress to blindness and disfigurement. Recently, we conducted 4 different temporalis muscle transfer (TMT) methods over the last 4 years to reduce ptosis. The methods used included Brown-McDowell, McCord-Codner, modified Gillies-Anderson, and modified Gillies...
January 2016: Journal of Craniofacial Surgery
Kofi D Owusu Boahene
Temporalis muscle tendon unit (MTU) transfer may be used as a single-stage procedure for dynamic reanimation of the paralyzed face. Principles and biomechanics of muscle function and tendon transposition are essential in optimizing outcome. Critical steps and pearls for success include minimizing scarring, maintaining glide plains, mobilizing adequate tendon length, insertion of MTU at ideal tension based on intraoperative dynamic tension-excursion relationship, and insertion of tendon as close to the lip margin as possible...
February 2016: Facial Plastic Surgery Clinics of North America
Brianna N Harris, Travis T Tollefson
PURPOSE OF REVIEW: The purpose of this article is to review and evaluate the surgical options for treating patients with facial paralysis, covering primary neurorrhaphy to facial reanimation, with microvascular free tissue transfer. RECENT FINDINGS: In recent years, free tissue transfer has been increasingly common for rehabilitating the paralyzed face, providing a more dynamic and aesthetic outcome, than has been possible prior to microvascular surgery in facial plastic and head and neck surgery...
October 2015: Current Opinion in Otolaryngology & Head and Neck Surgery
Orhan Ozturan, Berke Ozucer, Azize Esra Gursoy
UNLABELLED: Facial paralysis is a significant functional and aesthetic handicap. Many techniques have been defined for facial reanimation. The aim of the study was to evaluate postoperative electromyographical (EMG) activity of temporalis muscle to assess the potential neural impairments related to the surgical procedure. METHODOLOGY: Four patients with facial paralysis were operated with the temporalis muscle tendon transfer technique. Simultaneous surface electromyographic (sEMG) activity at first postoperative year from the bilateral temporalis and masseter muscles was obtained at mandibular rest position and then during maximal clenching...
September 2015: Journal of Craniofacial Surgery
Michael Fritz, Bryan N Rolfes
Treatment of advanced parotid or cutaneous malignancies often requires sacrifice of the facial nerve as well as resection of the parotid gland and surrounding structures. In addition to considerations regarding reinnervation and dynamic reanimation, reconstruction in this setting must take into account unique factors such as soft tissue volume deficits and the high likelihood of adjunctive radiation therapy. Furthermore, considerations of patient comorbidities including advanced age and poor long-term prognosis often influence reconstructive modality...
April 2015: Facial Plastic Surgery: FPS
Kofi Boahene
Facial paralysis following acoustic neuroma (AN) resection can be devastating, but timely and strategic intervention can minimize the resulting facial morbidity. A central strategy in reanimating the paralyzed face after AN resection is to restore function of the native facial muscles using available facial nerves or repurposed cranial nerves, mainly the hypoglossal or masseter nerves. The timing of reinnervation is the single most influential factor that determines outcomes in facial reanimation surgery. The rate of recovery of facial function in the first 6 months following AN resection may be used to predict ultimate facial function...
April 2015: Facial Plastic Surgery: FPS
Gang Chen, Xianxian Yang, Wei Wang, Qingfeng Li
Facial paralysis is a common craniofacial deformity that is responsible for significant psychological and functional impairment. Free muscle transfer in 2 stages and latissimus dorsi transfer in one stage may be the most effective surgical procedure for achieving a symmetrical spontaneous smile for a patient with complete facial paralysis. However, these 2 procedures are unsuitable for many incomplete patients. The authors introduce a less invasive procedure, termed mini-temporalis transposition that is able to achieve a symmetrical spontaneous smile in incomplete patients...
March 2015: Journal of Craniofacial Surgery
Rajanya S Petersson, Daniel E Sampson, James D Sidman
IMPORTANCE: To our knowledge, orthodromic temporalis tendon transfer (OTTT) for dynamic facial reanimation has not been described for use in children. OBSERVATIONS: Three pediatric patients with permanent facial paralysis underwent OTTT using our modified technique between August 30, 2010, and January 23, 2012. Outcomes were assessed by the surgeons, patients, and patient families, with the longest follow-up period being 13 months after surgery. Two patients were 4 years old at the time of surgery, and the third patient was 17 years old...
November 2014: JAMA Facial Plastic Surgery
Kofi D O Boahene, Lisa E Ishii, Patrick J Byrne
IMPORTANCE: The temporalis muscle has the potential to substitute for the function of paralyzed facial muscles in a single-stage procedure when transferred as a muscle-tendon unit (MTU). OBJECTIVE: To measure the available excursion of the temporalis MTU after release from the coronoid. DESIGN, SETTING, AND PARTICIPANTS Thirteen consecutive patients undergoing the temporalis MTU transfer procedure for facial reanimation participated in this study in an academic research setting...
January 2014: JAMA Facial Plastic Surgery
Douglas M Sidle, Patrick Simon
PURPOSE OF REVIEW: Temporalis tendon transfer is a technique for dynamic facial reanimation. Since its inception, nearly 80 years ago, it has undergone a wealth of innovation to produce the modern operation. The purpose of this review is to update the literature as to the current techniques and perioperative management of patients undergoing temporalis tendon transfer. RECENT FINDINGS: The modern technique focuses on the minimally invasive approaches and aesthetic refinements to enhance the final product of the operation...
August 2013: Current Opinion in Otolaryngology & Head and Neck Surgery
Kofi D O Boahene
Muscle tendon unit (MTU) transfer is a common procedure performed to restore hand function after peripheral nerve or spinal cord injury. The principles of MTU transfer established for hand surgery can be adopted to optimize the dynamic excursion of the temporalis tendon transfer procedure for facial reanimation. Additionally, the force generating ability of a transferred MTU depends on the ideal length-tension relationship of the donor muscle. There are unclear guideline for selecting the ideal tension at which a transferred MTU will generate maximum force and excursion and current practice often leads to overstretch and suboptimal actin myosin interaction...
February 2013: Laryngoscope
D Labbè, F Bussu, A Iodice
Long-standing peripheral monolateral facial paralysis in the adult has challenged otolaryngologists, neurologists and plastic surgeons for centuries. Notwithstanding, the ultimate goal of normality of the paralyzed hemi-face with symmetry at rest, and the achievement of a spontaneous symmetrical smile with corneal protection, has not been fully reached. At the beginning of the 20(th) century, the main options were neural reconstructions including accessory to facial nerve transfer and hypoglossal to facial nerve crossover...
June 2012: Acta Otorhinolaryngologica Italica
Garrett R Griffin, Waleed Abuzeid, Jeffrey Vainshtein, Jennifer C Kim
OBJECTIVE: To compare objective outcomes and complications following temporalis tendon transfer in patients with and without a history of radiation to the parotid bed. METHODS: Retrospective medical chart review comparing dynamic movement of the oral commissure and resting symmetry achieved in 7 irradiated patients (group R) and 7 nonirradiated patients (group N) after temporalis tendon transfer for unilateral facial paralysis. RESULTS: There were no significant differences between the 2 groups of patients in terms of age, additional facial reanimative procedures, baseline lip position, or follow-up time...
November 2012: Archives of Facial Plastic Surgery
Peter C Revenaugh, P Daniel Knott, Joseph Scharpf, Michael A Fritz
Background Extirpation of aggressive parotid or cutaneous facial tumors often involves facial nerve sacrifice and the creation of a large soft-tissue defect. We describe a method for single-stage reconstruction during radical parotidectomy to restore facial form and function without additional morbidity. Methods We conducted a review of immediate reconstruction/reanimation of radical parotidectomy defects with the use of anterolateral thigh (ALT) fat and fascia flaps for facial contouring, orthodromic temporalis tendon transfer (OTTT), cable grafting of the facial nerve, and fascia lata lower lip suspension...
March 2012: Archives of Facial Plastic Surgery
Noah P Parker, Lindsay S Eisler, Harley S Dresner, William E Walsh
OBJECTIVES: To define (1) at-risk structures during the orthodromic temporalis tendon transfer and (2) achievable tendon length without temporal releasing incisions or perioral lengthening materials. METHODS: Ten fresh cadavers provided 20 hemifaces for dissection. Measurements and photographic documentation were used to examine the parotid duct, masseteric artery, inferior alveolar nerve, internal maxillary artery, and mobilized tendon relative to adjacent landmarks...
January 2012: Archives of Facial Plastic Surgery
Jason Y K Chan, Patrick J Byrne
Facial paralysis is a clinical entity associated with significant morbidity, which has a treatment paradigm that is continually evolving. Surgical management of the paralyzed face poses significant challenges to achieve the goal of returning patients to their premorbid states. Here we attempt to review the advances in facial reanimation, in particular with regards to chronic facial paralysis. These include recent developments in static and dynamic rehabilitation including advances like artificial muscles for eyelid reconstruction, dynamic muscle transfer for the eye, and orthodromic temporalis tendon transfer...
August 2011: Facial Plastic Surgery: FPS
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