Biomechanical Comparison of the Temporalis Muscle Fascia, the Fascia Lata, and the Dura Mater

Abstract

The purpose of our research is to prove that elastic biomechanical characteristics of the temporalis muscle fascia are comparable to those of the fascia lata, which makes the temporalis muscle fascia adequate material for dural reconstruction in the region of the anterior cranial fossa. Fifteen fresh human cadavers, with age range from 33 to 83 years (median age: 64 years; mean age: 64.28 years), were included in the biomechanical study. Biomechanical stretching test with the comparison of elasticity among the tissues of the temporalis muscle fascia, the fascia lata, and the dura was performed. The samples were stretched up to the value of 6% of the total sample length and subsequently were further stretched to the maximum value of force. The value of extension at its elastic limit for the each sample was extrapolated from the force–extension curve and was 6.3% of the total sample length for the fascia lata (stress value of 14.61 MPa), 7.4% for the dura (stress value of 6.91 MPa), and 8% for the temporalis muscle fascia (stress value of 2.09 MPa). The dura and temporalis muscle fascia shared the same biomechanical behavior pattern up to the value of their elastic limit, just opposite to that of the fascia lata, which proved to be the stiffest among the three investigated tissues. There was a statistically significant difference in the extension of the samples at the value of the elastic limit for the fascia lata in comparison to the temporalis muscle fascia and the dura (p = 0.002; Kruskal–Wallis test). Beyond the value of elastic limit, the temporalis muscle fascia proved to be by far the most elastic tissue in comparison to the fascia lata and the dura. The value of extension at its maximum value of force for the each sample was extrapolated from the force–extension curve and was 9.9% of the sample's total length for the dura (stress value of 10.02 MPa), 11.2% for the fascia lata (stress value of 23.03 MPa), and 18.5% (stress value of 3.88 MPa) for the temporalis muscle fascia. There was a statistically significant difference in stress values at the maximum value of force between the dura and the temporalis muscle fascia (p = 0.001; Mann–Whitney U test) and between the dura and the fascia lata (p < 0.001; Mann–Whitney U test). Because of its elasticity and similarity in its mechanical behavior to the dura, the temporalis muscle fascia can be considered the most suitable tissue for dural reconstruction.

Biomechanical characterization of human temporal muscle fascia in uniaxial tensile tests for graft purposes in duraplasty

“…The considerable scatter in tensile strength values reported by Trindade et al 16 might be explained, potentially, by a non-uniform testing orientation of the samples. The here given work as well as other previous mechanical characterizations of the human TMF 14 , 15 orientated the samples longitudinally to the predominant collagen orientation, and may in consequence lead to more uniform ultimate tensile strength values. As a consequence of the lacking and inconsistent biomechanical properties in literature, the TMF has so far been neglected in computational and physical models of the temporomandibular joint or the entire human head 42 – 49 .…”

“…Puksec et al tested TMF samples using a uniaxial setup and a displacement velocity of 0.05 mm/s 15 . As revealed in this given study Puksec et al stated a more elastic behavior of the TMF as compared to the dura mater samples’ elastic limit of 6% strain, however, without reporting an elastic modulus 15 . The ultimate tensile strength of TMF in their study of 3.9 MPa could be substantiated in our study, investigating about fourfold their sample size and a broader age range under standardized conditions.…”

“…Biomechanical properties of the human TMF have barely been investigated before [14][15][16] with a maximum of 16 tested TMF samples very recently 15 . Puksec et al tested TMF samples using a uniaxial setup and a displacement velocity of 0.05 mm/s 15 .…”

“…Biomechanical properties of the human TMF have barely been investigated before [14][15][16] with a maximum of 16 tested TMF samples very recently 15 . Puksec et al tested TMF samples using a uniaxial setup and a displacement velocity of 0.05 mm/s 15 . As revealed in this given study Puksec et al stated a more elastic behavior of the TMF as compared to the dura mater samples' elastic limit of 6% strain, however, without reporting an elastic modulus 15 .…”

“…In spite of this empiric experience, thorough evidence is missing on the mechanical properties of the TMF providing a suitable substitute for dura repair. Conducted mechanical experiments to date were based on small sample sizes (with a maximum of 16 tested samples) and may consequently not be representative [14][15][16] . Wellgrounded biomechanical TMF properties may allow for mechanical comparison with dura mater, which is of interest given that the TMF transplant is exposed to deformation and flexing forces similar to the dura mater itself.…”