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Two-stage temporalis flap reconstruction for facial paralysis

  • Ben D. Buchholtz (a1), Robert A. Mickel (a2), James K. Bredenkamp (a1) and Robert W. Hutcherson (a1)

Abstract

Treatment of the paralyzed face remains a challenging surgical problem. When facial nerve damage is irreparable or facial nerve grafting has failed, static and dynamic techniques must be considered. A two-staged modification of the dynamic muscle transfer using ipsilateral temporalis muscle is described. Initially, a free temporalis fascia graft, harvested from the contralateral scalp, is placed around the oral commissure of the paralyzed side of the face through an incision in the nasolabial crease. Several weeks later, an ipsilateral temporalis muscle and fascia transfer is made to the anterior face and attached to the previously placed fascia graft. Oral commissure grafting, as a first step, provides for a secure anchoring point for the temporalis flap, and achieves a more satisfactory correction of the oral commissure.

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Corresponding author

Robert A. Mickel, M.D., Ph.D., Division of Head and Neck Surgery (W112C), West Los Angeles VA Medical Center, Wilshire and Sawtelle Blvds., Los Angeles, CA 90073, U.S.A.

References

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Baker, D. C. and Conley, J. (1979). Regional muscle transposition for rehabilitation of the paralyzed face. Clinics in Plastic Surgery, 6: 317331.
Freeman, B. S. (1977) Facial Palsy, in Reconstructive Plastic Surgery (Converse, J. M. ed.), vol. 3, p. 17741867. WB Saunders Co: Philadelphia.
May, M. (1984a). Muscle transposition for facial reanimation: Indications and results. Otolaryngology-Head and Neck Surgery, 92: 8587.
May, M. (1984b) Muscle transposition for facial reanimation. Archives of Otolaryngology, 110: 184189.
Rubin, L. R. (1977) Reanimation of the Paralyzed Face. CV Mosby Co: St. Louis.

Two-stage temporalis flap reconstruction for facial paralysis

  • Ben D. Buchholtz (a1), Robert A. Mickel (a2), James K. Bredenkamp (a1) and Robert W. Hutcherson (a1)

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