title: [Electromyographic assessment of the temporalis muscle prior to a lengthening myoplasty in patients with Moebius syndrome].
abstract: OBJECTIVE
  Temporalis muscle lengthening myoplasty improves tightening of the lips and rehabilitates smile for patients with congenital facial palsies. Because Moebius syndrome is heterogeneous, a careful evaluation is mandatory before deciding to perform myoplasty. This series shows the role of electromyography for investigating temporalis muscle and trigeminal nerve motor functions.
  
  
  METHODS
  We conducted a retrospective study of 18 patients with no upward movements of the labial commissure and absent or unsightly smile. Electromyography was used to study the temporalis muscle bilaterally. Analysis focused on the recruitment pattern of voluntary contraction and electrical silence or activity at rest. Traces were classified as normal, neurogenic, or low-amplitude. Functional outcomes of myoplasty were evaluated by measuring the upward movement of the commissure (mm), and qualified as high (≥10), medium (>5), or little (≤5).
  
  
  RESULTS
  Surgery was cancelled for 5 patients with abnormal electromyographic signs, neurogenic (2) or low-amplitude (3). Myoplasty was performed in 7 patients (age: 8-17 years), unilaterally (3) or bilaterally (4). Preoperative electromyogram was normal (3), or showed moderate neurogenic (2) or low-amplitude (2) changes. Follow-up period after surgery was from 2 to 12 years; functional outcomes were high (5), medium (1), or little (1).
  
  
  CONCLUSIONS
  Electromyographic study of the temporalis can detect muscle denervation or atrophy, or dyspraxia, and guide decision to encourage or discourage performing myoplasty, or enhance rehabilitation programme and make the patient aware of possibly modest outcome.
authors.affiliation: Centre de référence des malformations rares de la face et de la cavité buccale, hôpital Necker-Enfants-Malades, AP-HP, 75743 Paris 15, France; Unité de neurophysiologie clinique de l'enfant, hôpital Armand-Trousseau, AP-HP, 75571 Paris 12, France. Electronic address: docteur.frenault@wanadoo.fr.
authors.forename: F
authors.initials: F
authors.lastname: Renault
authors.affiliation: Centre de référence des malformations rares de la face et de la cavité buccale, hôpital Necker-Enfants-Malades, AP-HP, 75743 Paris 15, France; Service de chirurgie maxillo-faciale et chirurgie plastique de l'enfant, hôpital Necker-Enfants-Malades, AP-HP, 75743 Paris 15, France.
authors.forename: B
authors.initials: B
authors.lastname: Sergent
authors.affiliation: Centre de référence des malformations rares de la face et de la cavité buccale, hôpital Necker-Enfants-Malades, AP-HP, 75743 Paris 15, France.
authors.forename: V
authors.initials: V
authors.lastname: Charpillet
authors.affiliation: Centre de référence des malformations rares de la face et de la cavité buccale, hôpital Necker-Enfants-Malades, AP-HP, 75743 Paris 15, France; Service d'explorations fonctionnelles, hôpital Necker-Enfants-Malades, AP-HP, 75743 Paris 15, France.
authors.forename: C
authors.initials: C
authors.lastname: Gitiaux
authors.affiliation: Centre de référence des malformations rares de la face et de la cavité buccale, hôpital Necker-Enfants-Malades, AP-HP, 75743 Paris 15, France; Service de chirurgie maxillo-faciale et chirurgie plastique de l'enfant, hôpital Necker-Enfants-Malades, AP-HP, 75743 Paris 15, France; Faculté de médecine Paris Descartes, université Paris 5, 75743 Paris 15, France.
authors.forename: M-P
authors.initials: MP
authors.lastname: Vazquez
mesh_terms: D000293:Adolescent; D002648:Child; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D020331:Mobius Syndrome / Q000503:physiopathology / Q000601:surgery*; D009119:Muscle Contraction / Q000502:physiology; D011999:Recruitment, Neurophysiological / Q000502:physiology; D012189:Retrospective Studies; D012904:Smiling / Q000502:physiology; D013703:Temporal Muscle / Q000503:physiopathology*; D014276:Trigeminal Nerve / Q000503:physiopathology
keywords: Congenital facial palsy; Electromyography; Lengthening temporalis myoplasty; Moebius syndrome; Myoplastie d’allongement du temporalis; Paralysie faciale congénitale; Réhabilitation du sourire; Smile rehabilitation; Syndrome de Moebius; Électromyographie