title: Recycle of temporal muscle in combination with free muscle transfer in the treatment of facial paralysis.
abstract: We experienced three patients with long-standing unilateral complete facial paralysis who previously underwent temporalis muscle transfer to the cheek for smile reconstruction. All patients complained of insufficient and uncomfortable buccal motion synchronised with masticatory movements and incomplete eyelid closure with ptotic eyebrow. To attain a near-natural smile and reliable eyelid closure, temporalis muscle was displaced from the cheek to the eyelid, and a neurovascular free latissimus dorsi muscle was transferred for the replacement of cheek motion. As a result, cheek motion synchronised with the contralateral cheek upon smiling and sufficient eyelid closure were obtained in all cases. Smile reconstruction using the temporal muscle is an easy and a versatile way in general. However, spontaneous smile is not achieved and peculiar movement of the cheek while eating is conspicuous in some cases. Replacement with neurovascular free latissimus dorsi muscle and recycling previously used temporalis muscle for eyelid closure are considered to be valuable for such cases.
authors.affiliation: Department of Plastic Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan. masakazukurita@aol.com
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kurita
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takushima
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Mikio
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Mine
authors.initials: M
authors.lastname: Ozaki
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Harii
mesh_terms: D004954:Esthetics; D005149:Facial Expression; D005158:Facial Paralysis / Q000175:diagnosis / Q000601:surgery*; D005206:Fascia Lata / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000601:surgery / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D012677:Sensation / Q000502:physiology; D012720:Severity of Illness Index; D013703:Temporal Muscle / Q000601:surgery / Q000637:transplantation*; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome