title: Orthodromic transfer of the temporalis muscle in incomplete facial nerve palsy.
abstract: BACKGROUND
  Temporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients.
  
  
  METHODS
  Between August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs.
  
  
  RESULTS
  The symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery.
  
  
  CONCLUSIONS
  The orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Aum
authors.forename: Dong Hee
authors.initials: DH
authors.lastname: Kang
authors.forename: Sang Ah
authors.initials: SA
authors.lastname: Oh
authors.forename: Ja Hea
authors.initials: JH
authors.lastname: Gu
keywords: Facial paralysis; Fascia lata; Temporal muscle
references.citation: Plast Reconstr Surg. 2010 Jul;126(1):118-125
references.pmid: 20595862
references.citation: Clin Plast Surg. 1979 Jul;6(3):317-31
references.pmid: 385211
references.citation: J Plast Reconstr Aesthet Surg. 2012 Jul;65(7):851-6
references.pmid: 22445694
references.citation: Arch Facial Plast Surg. 2007 Jul-Aug;9(4):234-41
references.pmid: 17638756
references.citation: Plast Reconstr Surg. 2012 Feb;129(2):340e-352e
references.pmid: 22286449
references.citation: Plast Reconstr Surg (1946). 1953 Apr;11(4):302-14
references.pmid: 13055475
references.citation: Plast Reconstr Surg. 2000 Apr;105(4):1289-97; discussion 1298
references.pmid: 10744217
references.citation: Isr Med Assoc J. 2007 Feb;9(2):123-4
references.pmid: 17348489
references.citation: Otolaryngol Head Neck Surg. 2011 Jul;145(1):18-23
references.pmid: 21493262
references.citation: Plast Reconstr Surg. 1974 Apr;53(4):384-7
references.pmid: 4815693
references.citation: Br J Plast Surg. 1996 Jan;49(1):46-51
references.pmid: 8705102
references.citation: Arch Otolaryngol Head Neck Surg. 1993 Apr;119(4):378-82; discussion 383-4
references.pmid: 8457301
references.citation: J Craniofac Surg. 2005 Mar;16(2):306-9
references.pmid: 15750430
references.citation: Proc R Soc Med. 1934 Aug;27(10):1372-82
references.pmid: 19989927