Temporalis Tendon Transfer as Part of a Comprehensive Approach to Facial Reanimation

Byrne, Patrick J.; Kim, Michael; Boahene, Kofi; Millar, Jennifer; Moe, Kris S.

doi:10.1001/archfaci.9.4.234

Cited by 104 publications

(65 citation statements)

References 13 publications

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“…All patients underwent OTTT as described by Byrne et al, 10 with modifications by the senior author (M.A.F.). All tendon transfers were accomplished using a transfacial (3 patients) or combined transfacial/transoral (2 patients) route if exposure was not adequate through resection defect.…”

Section: Resultsmentioning

confidence: 99%

“…The procedure has seen a resurgence in popularity in recent years, with several modifications providing an orthodromic force vector while eliminating the asymmetry and much of the morbidity of the original procedure. 10,28 In parotidectomy defects, access to the coronoid via the transfacial approach simplifies the procedure and reduces operative time by eliminating the need for intraoral incisions (Figure 2). Original descriptions of the technique aimed at melolabial fold reconstitution with corner-of-mouth movement.…”

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

Simultaneous Anterolateral Thigh Flap and Temporalis Tendon Transfer to Optimize Facial Form and Function After Radical Parotidectomy

Revenaugh

Knott²,

Scharpf³

et al. 2012

Arch Facial Plast Surg

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Section: Resultsmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Simultaneous Anterolateral Thigh Flap and Temporalis Tendon Transfer to Optimize Facial Form and Function After Radical Parotidectomy

Revenaugh

Knott²,

Scharpf³

et al. 2012

Arch Facial Plast Surg

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“…Las técnicas estáticas, que solo buscan equilibrar la asimetría facial a través de tracciones, están siendo desplazadas por técnicas dinámicas de cada vez mayor complejidad y que buscan, además, dotar de movimiento al lado afectado (4,8,9,14) .…”

Section: Discussionunclassified

“…Para ello, se hace la comparación respectiva con el lado sano y se utiliza fotos anteriores a la parálisis. Los tipos de sonrisa, según la clasificación de Rubín, pueden ser: de Mona lisa, tipo canina y por último la tipo completa o full teeth (11)(12)(13)(14) (figura 3).…”

Section: Evaluación Preoperatoriaunclassified

Parálisis facial permanente: corrección quirúrgica con la técnica de Labbé

Yangali¹,

Neme²,

Moreno

et al. 2013

An Fac med

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ResumenLa parálisis facial genera un gran déficit estético y funcional. Las diversas técnicas quirúrgicas han ido evolucionando, a fin de corregir este defecto de la forma más estructural y fisiológica posible. Consideramos que la mioplastia de alargamiento del temporal constituye actualmente la técnica de elección para corregir los casos de parálisis facial permanente.Palabras clave: Parálisis facial; nervio facial; cirugía; músculo temporal. AbstractFacial paralysis causes a large aesthetic and functional defect. Different surgical techniques may be used to repair this defect. Some of them have focused in structural and physiological aspects. We consider that temporalis lengthening myoplasty is currently the most important technique for permanent facial paralysis repair.Key words: Facial paralysis; facial nerve; surgery; temporal muscle. INTRODUCCIÓNLa parálisis facial permanente es siempre una entidad mal tolerada por la persona afectada. Los problemas tanto estéticos como funcionales que esta produce, generan siempre gran frustración en el paciente. La asimetría facial, la dificultad para hablar, la incontinencia salival, la epífora y la afectación corneal en el ojo del lado afectado son algunas de las manifestaciones más características.Esta entidad es producida por lesión del nervio facial (VII par craneal), sea a nivel de sus núcleos formadores en el tronco cerebral o a cualquier nivel de su trayecto. Dicho trayecto se inicia en el bulbo raquídeo, pasa por la base del cráneo y termina en diversas ramas que atraviesan la parótida, para finalmente inervar los músculos faciales. Es por ello que, dependiendo del nivel de la injuria, podemos tener parálisis faciales totales o parciales. Entre las causas más frecuentes de injuria al nervio facial se encuentran los tumores, los procedimientos quirúrgi-cos y las causas idiopáticas (1)(2)(3)(4) .Muchos procedimientos quirúrgicos han sido ideados con el fin de mejorar las secuelas producidas por una parálisis facial permanente, técnicas quirúrgicas que van desde simples tracciones, con el fin de equilibrar la asimetría facial; son conocidas también como técnicas estáticas (interposición y tracción con fascia autóloga, hilos rusos, entre otros) (5,6) (figura 1). Y otras que pretenden dotar de cierta movilidad al lado afectado, como anastomosis hipoglosofacial, colgajos fasciomusculares y recientemente técnicas más complejas, que buscan dar movilidad voluntaria al lado afectado, consiguiéndose incluso sonrisas espontáneas, conocidas como técnicas dinámicas (7)(8)(9)(10) .La mioplastia de alargamiento del músculo temporal, técnica dinámica e innovadora, dada a conocer por Labbé en esta década, constituye actualmente una de las mejores técnicas para el tratamiento de la parálisis facial permanente, ya que no solo mejora la simetría facial, sino que además mejora la incontinencia salival, el tono facial, mejora el habla, dota al paciente de movimiento en el lado afectado, así como la capacidad de volver a sonreír. Evocando antiguas técnicas, como la de Gilles (1934) (...

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“…While the degree of voluntary facial movement generated through this procedure is variable, surgical outcomes that establish immediate facial symmetry and support are nearly universal. [6][7][8] These outcomes are in part due to the natural orientation of the temporalis tendon in a vector nearly identical to midface mimetic musculature. It is this ability to rapidly establish symmetry and maintain facial function with autogenous tissue (irrespective of radiation therapy) that has made OTTT the ideal method of reanimation in the oncologic setting.…”

Section: Introductionmentioning

confidence: 99%

Management of Facial Paralysis due to Extracranial Tumors

Fritz

Rolfes

2015

Facial plast Surg

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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. The optimal reconstructive technique would provide potential for restoration of facial tone and voluntary movement as well as immediate restoration of facial support and function. Beyond considerations of facial movement and rest position, restoration of lost soft tissue volume is critical to obtain facial symmetry. To control long-term volume in the setting of adjunctive radiation therapy, vascularized tissue is required. In this chapter, we describe a comprehensive approach to the management of radical parotidectomy and similar facial defects that addresses these concerns and also describes management strategies over time. Specific techniques employed include anterolateral thigh free flaps, nerve grafting utilizing motor nerves to the vastus lateralis muscle, and orthodromic temporalis tendon transfer. Further considerations relative to the eye, forehead, and long-term facial refinement are also discussed.

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Temporalis Tendon Transfer as Part of a Comprehensive Approach to Facial Reanimation

Cited by 104 publications

References 13 publications

Simultaneous Anterolateral Thigh Flap and Temporalis Tendon Transfer to Optimize Facial Form and Function After Radical Parotidectomy

Simultaneous Anterolateral Thigh Flap and Temporalis Tendon Transfer to Optimize Facial Form and Function After Radical Parotidectomy

Parálisis facial permanente: corrección quirúrgica con la técnica de Labbé

Management of Facial Paralysis due to Extracranial Tumors

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