Temporalis tendon release during mandibular sagittal ramus split osteotomy
| Autor: | Ronald M. Kaminishi, Michael W. Marshall, W. Howard Davis |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Periosteum
business.industry medicine.medical_treatment Mandible Temporal Muscle Anatomy musculoskeletal system Osteotomy Temporal muscle Sagittal plane Tendons medicine.anatomical_structure stomatognathic system Otorhinolaryngology Cadaver medicine Humans Surgery Oral Surgery Cadaveric spasm business Lingual nerve |
| Zdroj: | Journal of Oral and Maxillofacial Surgery. 52:885-887 |
| ISSN: | 0278-2391 |
| DOI: | 10.1016/0278-2391(94)90244-5 |
| Popis: | Since the original description of the sagittal ramus six dissected specimens (Fig 2). The lingual nerve was also identified and found to be consistently inferior and medial to the temporalis tendon. The tendinous tissue was always easily distinguishable from nerve tissue. The lingual nerve location has been previously described as being on average 0.58 mm + 0.9 horizontally from the lingual plate and 2.28 mm f 1.96 on the average vertically below the alveolar crest (Fig 3).5 This location, verified in the cadaveric dissections, is clearly distinct from the location of the temporalis tendon. split osteotomy by Obwegeser,’ there have been a number of modifications to decrease relapse, reduce complications, and improve the ease with which the osteotomy is performed. Most modifications have dealt with changes in osteotomy design or soft tissue reflection.2.3 Our modification focuses on the insertion of the temporalis muscle and its influence on medial access, tissue reflection, and relapse. It involves elevation and transection of the tendonous insertion of the anterior temporalis muscle along the medial aspect of the mandibular body. Classically, the insertion of the temporalis muscle is described as being into the upper and anterior borders of the coronoid process, with the major portion on the medial side of the ramus and entire medial side of the coronoid. However, Hollinshead4 also found the anterior temporalis insertion to include the anterior part of the ramus, extend’hrg approximately to the third molar region.4 Clinically this is seen as a horizontal tendinous band that runs along the internal oblique ridge just superficial to the periosteum. It is found directly medial to the most common soft tissue incision used for the bilateral sagittal ramus split osteotomy, and is exposed and reflected each time the medial ramus is approached, often appearing as a tight band. After the sagittal ramus split osteotomy, the tendinous insertion remains attached to the distal or advancing segment of the mandible (Fig 1). This structure is easily indentified and has been verified on multiple cadaveric dissections. On exposure of the anterior insertion, the temporalis tendon was found to extend to the distal aspect of the second molar tooth in each of |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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