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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

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Endoscopic Temporalis Tendon Extension (ETTE).

Marco Bonali¹, Claudio Melchiorri¹, Costanza Galloni¹

¹Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena , Azienda Ospedaliero-Universitaria di Modena, Largo del Pozzo, 71, Modena 41125, Italy.

Journal of Stomatology, Oral and Maxillofacial Surgery

|September 14, 2023

Summary

This study introduces the Endoscopic Temporalis Tendon Extension (ETTE) surgical technique for facial nerve palsy. ETTE restores facial symmetry using a static and dynamic approach, improving patient outcomes.

Keywords:

Dynamic rehabilitation techniques Endoscopic assistance Facial nerve palsy Fascia lata graft Orbicularis oris modiolus Temporalis muscle tendon

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Area of Science:

Plastic Surgery
Neurosurgery
Otolaryngology

Background:

Facial nerve palsy significantly impacts facial symmetry and quality of life.
Existing surgical techniques for facial symmetry restoration have limitations.

Purpose of the Study:

To present and evaluate the Endoscopic Temporalis Tendon Extension (ETTE) surgical technique.
To assess the efficacy of ETTE in restoring facial symmetry in patients with facial nerve palsy.

Main Methods:

The ETTE procedure involves a nasolabial incision and endoscopic dissection.
Key steps include masseter muscle detachment, coronoid process sectioning (Piezosurgery®), and fascia lata graft suspension.
The technique combines static suspension and dynamic muscle contraction components.

Main Results:

ETTE utilizes the preserved temporalis muscle for optimal contraction.
A fascia lata graft provides necessary length for the suspension.
The nasolabial incision aids in recreating the nasolabial fold, enhancing aesthetic results.

Conclusions:

Endoscopic Temporalis Tendon Extension (ETTE) is an effective surgical approach for facial symmetry restoration.
The technique offers both static and dynamic components for improved functional and aesthetic outcomes.
Endoscopic assistance enhances procedural precision and reduces the learning curve for surgeons.