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Orthodromic temporalis tendon transfer: anatomical considerations
Noah P Parker1, Lindsay S Eisler, Harley S Dresner
1Department of Otolaryngology-Head and Neck Surgery, University of Minnesota Medical Center, 420 Delaware St. SE, Minneapolis, MN 55455, USA.
Archives of Facial Plastic Surgery
|January 18, 2012
Summary
This study identified critical anatomical structures at risk during orthodromic temporalis tendon transfer. The temporalis tendon alone typically provides sufficient length for facial suspension without additional lengthening materials.
Area of Science:
- Anatomy
- Surgical Procedures
- Facial Reconstruction
Background:
- Orthodromic temporalis tendon transfer is a reconstructive technique.
- Understanding anatomical risks is crucial for surgical success.
Purpose of the Study:
- Define at-risk structures during orthodromic temporalis tendon transfer.
- Determine achievable tendon length without additional lengthening.
Main Methods:
- Dissection of 20 hemifaces from 10 fresh cadavers.
- Photographic documentation and measurements of key anatomical landmarks and the mobilized tendon.
Main Results:
- Identified reproducible locations for the parotid duct, masseteric artery, inferior alveolar nerve, and internal maxillary artery.
- The temporalis tendon achieved adequate length beyond the melolabial crease in 85% of cases.
Conclusions:
- The melolabial crease and parotid duct reference line aid in locating the parotid duct.
- Careful soft-tissue handling is essential to avoid neurovascular injury.
- The temporalis tendon typically offers sufficient length for orthodromic suspension.