Muscle Transposition for Facial Reanimation: Indications and Results

Abstract

\s=b\The technique of transposing the temporalis and masseter muscles to reanimate the face following long-standing facial paralysis was introduced at the turn of the century. More recently it has been popularized by Rubin and Conley. The indications for performing this technique are outlined, and the results are analyzed. (Arch Otolaryngol 1984;110:184-189) Rubi n1 and Baker and Conley2 popu¬ larized the technique of temporalis-masseter muscle transposition for facial reanimation, even though it was first advanced at the turn of the century by Lexer and Eden.3 As a student of Rubin and Conley, I appre¬ ciate the contributions of both sur¬ geons to the field of facial reanima¬ tion.Rubin has modified the muscle swing and stressed the importance of analyzing the facial expression on the normal side to create the mirror image on the uninvolved side. He

Temporalis Muscle for Facial Reanimation: A 13-Year Experience With 224 Procedures

“…(1) Temporalis muscle transposition is used exclusively to reanimate the mouth of a patient with facial paral¬ ysis. Eye reanimation is achieved by another technique.…”

Augmented fascia temporalis sling for paralytic ectropion of the lower lid

“…However, the dynamic procedures are technically difficult with limited success rates and particularly not necessary for the lower lid given its short range of excursion. 1–4,9,10…”

Revisiting Orthodromic Temporalis Transfer in Treating Long-Standing Facial Paralysis

“…18 Temporalis and masseter muscle transpositions have long been used in attempts to reanimate the face in long-standing facial paralysis. 13,[19][20][21][22] The choice of the appropriate muscle for transfer is based on the main vector of the contralateral smile. 23,24 In all patients included in this study, the principal vector of the contralateral smile was superolateral in the direction of pull of the zygomaticus major muscle.…”

“…Outcomes measured included patient satisfaction, objective measurements of oral commissure elevation with smiling, and physician grading of preoperative and postoperative patient photographs. The grading classification by Viterbo and de Paula Faleiros2 and May313 was adopted: 1, excellent (patient smiles voluntarily with exposure of the teeth); 2, good (discreet smile, pulling up the corner of the mouth); 3, average (facial asymmetry at rest); and 4, bad (no change). Postoperative complications were evaluated.…”