Facial plast Surg 2015; 31(02): 123-127
DOI: 10.1055/s-0035-1549039
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lengthening Temporalis Myoplasty: A Surgical Tool for Dynamic Labial Commissure Reanimation

Pierre Guerreschi1, Daniel Labbe2
  • 1Department of Plastic and Reconstructive Surgery, Hospital Roger Salengro, Lille Cedex, France
  • 2Department of Plastic and Reconstructive Surgery, Clinique Saint Martin, Caen, France
Further Information

Publication History

Publication Date:
08 May 2015 (online)

Abstract

Lengthening temporalis myoplasty (LTM), first described by Labbé in 1997, ensures the transfers of the entire temporal muscle from the coronoid process to the upper half of the lip without interposition of aponeurotic tissue. The temporal muscle changes function because it is entirely mobilized toward another effector: the labial commissure. Thanks to brain plasticity, the muscle loses its chewing function, and after 6 months of speech rehabilitation it acquires its new smiling function. We describe technical points especially the coronoid process approaches both through an upper temporal fossa approach and a lower nasolabial fold approach. Rehabilitation starts 3 weeks after the surgery following a standardized protocol to move from a mandibular smile to a voluntary, then spontaneous, smile in three steps. The LTM is the main part of a one-stage global treatment of the paralyzed face. It constitutes a dynamic palliative treatment usually started at the sequelae stage, 18 month after the outcome of a peripheral facial paralysis. This one-stage procedure is a reproducible and relevant surgical technique in the difficult treatment of peripheral facial paralysis. It allows implementing an active muscle transfer to reanimate the labial commissure and re-create a mobile nasolabial fold.