Keeping the fat on the right spot prevents contour deformity in temporalis muscle transposition
| Autor: | Paul M N Werker, Pieter U. Dijkstra, Steven F S Korteweg, Martinus M. van Veen |
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| Přispěvatelé: | Extremities Pain and Disability (EXPAND), Restoring Organ Function by Means of Regenerative Medicine (REGENERATE) |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty PARALYSIS Visual analogue scale Temporal Muscle Temporalis muscle Smiling Transposition (music) 03 medical and health sciences Postoperative Complications 0302 clinical medicine FACE Interquartile range Temporal bone medicine Paralysis Humans 030223 otorhinolaryngology Retrospective Studies business.industry Temporalis transposition 030206 dentistry Anatomy Middle Aged medicine.disease Facial paralysis Surgery Temporalis hollowing Cross-Sectional Studies Treatment Outcome medicine.anatomical_structure Adipose Tissue MYOFASCIAL FLAP Rhytidoplasty Female Zygomatic arch medicine.symptom business FACIAL REANIMATION |
| Zdroj: | Journal of Plastic Reconstructive and Aesthetic Surgery, 71(8), 1181-1187. ELSEVIER SCI LTD |
| ISSN: | 1748-6815 |
| DOI: | 10.1016/j.bjps.2018.04.007 |
| Popis: | The temporalis muscle transposition is a reliable, one-stage reanimation technique for longstanding facial paralysis. In the variation described by Rubin, the muscle is released from the temporal bone and folded over the zygomatic arch towards the modiolus. This results in unsightly temporal hollowing and zygomatic bulging. We present a modification of this technique, which preserves the temporal fat pad in its anatomical location as well as conceals temporal hollowing and prevents zygomatic bulging.The data of 23 patients treated with this modification were analysed. May classification was used for evaluation of mouth reanimation. Experts and patients scored visibility of the contour deformity on a 100-mm visual analogue scale (VAS) (score 0 = poor/100 = best). 3D images of the face were used to measure temporal hollowing and zygomatic bulging. 3D images were compared to those of controls with a similar gender and age distribution.After a median follow-up of 5.7 years, all patients achieved symmetry at rest. Eleven patients achieved symmetry while smiling with closed lips (May classification "Good"). A median (interquartile range [IQR]) VAS score of 19 (6; 41) was given by experts and 25 (5; 59) by patients themselves. 3D volumes of zygomatic bulging differed from those of control subjects, although all volume differences were small (medianOn the basis of our results, we conclude that our modified Rubin temporalis transposition technique provides an elegant way to conceal bulging over the zygomatic arch and prevents temporal hollowing, without the need for fascial extensions to reach the modiolus. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
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