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Two-stage temporalis flap reconstruction for facial paralysis

Published online by Cambridge University Press:  29 June 2007

Ben D. Buchholtz
Affiliation:
Division of Head and Neck Surgery, Department of Surgery, UCLA School of Medicine
Robert A. Mickel*
Affiliation:
VAMC West Los Angeles
James K. Bredenkamp
Affiliation:
Division of Head and Neck Surgery, Department of Surgery, UCLA School of Medicine
Robert W. Hutcherson
Affiliation:
Division of Head and Neck Surgery, Department of Surgery, UCLA School of Medicine
*
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.

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1989

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References

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