Temporalis Muscle Transposition in Irreversible Facial Nerve Palsy:‎ A Vestibular Approach

Area of Science:

• Plastic Surgery
• Neurology
• Reconstructive Surgery

Background:

• The facial nerve is vital for facial expressions and communication.
• Damage to the facial nerve causes significant functional, emotional, and social challenges.
• Irreversible facial nerve palsy leads to symptoms like eyelid defects and mouth deviation.

Purpose of the Study:

• To evaluate temporalis transfer with an intraoral approach for oral commissure reanimation in irreversible facial nerve palsy.
• To offer an alternative surgical solution for patients with facial nerve damage.
• To assess functional outcomes and patient suitability for this scarless technique.

Main Methods:

• 18 patients (15 female, 3 male) underwent temporalis transfer via an intraoral approach.
• Preoperative planning included smile evaluation and botulinum toxin injection on the unaffected side.
• The surgical procedure combined coronal and orbital approaches for cranio-orbito-palpebral unity.

Main Results:

• The temporalis transfer technique successfully reanimated the oral commissure.
• Functional outcomes showed a mean improvement of 2.5 on the House-Brackmann scale.
• Postoperative complications included hematomas and ossification; however, functional symmetry was achieved.

Conclusions:

• Temporalis transfer with an intraoral approach is a viable alternative for facial palsy reanimation.
• This technique is particularly beneficial for selected patients desiring scarless outcomes.
• Ideal candidates include young patients, those prone to scarring, and individuals with subtle nasolabial folds.