Lengthening temporalis myoplasty: A question of access

Abstract

The temporalis transfer has been used for restoration of symmetry and movement in facial palsy patients for many years. The original Gillies technique 1 Gillies H. Experiences with fascia lata grafts in the operative treatment of facial paralysis: (section of otology and section of laryngology). Proc R Soc Med. 1934; 27 (PMID: 19989927; PMCID: PMC2205492): 1372-1382 PubMed Google Scholar (1934) involved turning down the mid-section of the temporalis muscle and lengthening it by means of fascia lata strips. This created a significant bulge over the zygomatic arch, especially on clenching teeth, and left a depression in the temporal donor site. McLaughlin 2 McLaughlin C.R. Surgical support in permanent facial paralysis. Plast Reconstr Surg. 1953; 11 (1946)PMID: 13055475: 302-314https://doi.org/10.1097/00006534-195304000-00007 Crossref Scopus (89) Google Scholar described an orthrodomic temporalis transfer in 1953 that avoided these issues, but still required fascial extensions to reach the oral commissure and nasolabial fold. Labbé (1997) further modified the orthodromic temporalis transfer, so as to retain the advantages of the Mclaughlin technique but obviate the need for fascia lata extensions, and called his technique Lengthening Temporalis Myoplasty (LTM) 3 Labbé D. Myoplastie d'allongement du temporal et réanimation des lèvres: note technique. Ann Chir Plast Esthet. 1997; 42: 44 PubMed Google Scholar ,4 Labbé D. Huault M. Lengthening temporalis myoplasty and lip reanimation. Plast Reconstr Surg. 2000; 105 (discussion 1298. PMID: 10744217): 1289-1297 Crossref PubMed Scopus (147) Google Scholar . This procedure has since become well established as a reliable, single-stage muscle transfer for facial reanimation. A modification of the original LTM (version 2) was subsequently described in 2009. 5 Labbé D. Myoplastie d'allongement du temporal V.2. et réanimation des lèvres [Lenghtening temporalis myoplasty V.2. and lip reanimation]. Ann Chir Plast Esthet. 2009; 54 (DecFrenchEpub 2009 Jul 25. PMID: 19632753): 571-576https://doi.org/10.1016/j.anplas.2009.04.002 Crossref PubMed Scopus (27) Google Scholar