Management of temporal nerve injuries

Transection of the temporal branch of the facial nerve results in paralysis of the frontalis muscle with subsequent inability to wrinkle the forehead. In addition there is ptosis of the eyebrow with upper visual field defects. The intent of this article is to outline an orderly, rational approach to the management of such injuries based on our experience with seven patients whose nerve was damaged during Mohs surgery for cancer ablation. Repair options include various combinations of direct brow-plasty, indirect temporal or coronal browlifts, and adjunctive upper lid blepharoplasty.