Anchoring the detached temporalis muscle in craniofacial surgery

The temporalis muscle is often detached to enable craniofacial tumour and trauma access surgery. Failure to carefully handle and reattach the muscle often leads to a cosmetic and functional deformity. The authors discuss the principles of elevation of the whole temporal muscle within its surrounding fascia to reduce atrophy. The temporalis muscle is then reattached to its point of origin, using suspensory absorbable sutures attached to 3 mm titanium microscrews placed inferior to the limits of the muscle, to make them non-palpable. The aim is to reduce the postoperative temporal hollowing often seen when these principles are not observed. A series of cases using this technique are reported.