Open Access
CC BY-NC-ND 4.0 · Arch Plast Surg 2023; 50(01): 042-048
DOI: 10.1055/s-0042-1758469
Pediatric/Craniomaxillofacial/Head & Neck
Original Article

Surgical Anatomy of Temporalis Muscle Transfer with Fascia Lata Augmentation for the Reanimation of the Paralyzed Face: A Cadaveric Study

Yi Zhang 
1   Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, Vienna, Austria
2   Plastic and Reconstructive Surgery, Department of Surgery, Hospital Divine Saviour, Vienna, Austria
3   Department of Vascular Surgery, Agaplesion Diakonieklinikum Hamburg, Hamburg, Germany
,
Johannes Steinbacher 
2   Plastic and Reconstructive Surgery, Department of Surgery, Hospital Divine Saviour, Vienna, Austria
,
Wolfgang J. Weninger 
1   Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, Vienna, Austria
,
Ulrike M. Heber 
1   Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, Vienna, Austria
4   Institute of Pathology, Medical University of Vienna, Vienna, Austria
,
Lukas Reissig 
1   Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, Vienna, Austria
,
Erdem Yildiz 
1   Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, Vienna, Austria
5   Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
,
Chieh-Han J. Tzou 
2   Plastic and Reconstructive Surgery, Department of Surgery, Hospital Divine Saviour, Vienna, Austria
6   TZOU Medical, Vienna, Austria
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Funding No funding was received for this article.
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Abstract

Background The temporalis muscle flap transfer with fascia lata augmentation (FLA) is a promising method for smile reconstruction after facial palsy. International literature lacks a detailed anatomical analysis of the temporalis muscle (TPM) combined with fascia lata (FL) augmentation. This study aims to describe the muscle's properties and calculate the length of FL needed to perform the temporalis muscle flap transfer with FLA.

Methods Twenty nonembalmed male (m) and female (f) hemifacial cadavers were dissected to investigate the temporalis muscle's anatomy.

Results The calculated minimum length of FL needed is 7.03cm (f) and 5.99cm (m). The length of the harvested tendon is 3.16cm/± 1.32cm (f) and 3.18/± 0.73cm (m). The length of the anterior part of the temporalis muscle (aTPM) is 4.16/± 0.80cm (f) and 5.30/± 0.85cm (m). The length of the posterior part (pTPM) is 5.24/± 1.51cm (f) and 6.62/± 1.03cm (m). The length from the most anterior to the most posterior point (aTPMpTPM) is 8.60/± 0.98cm (f) and 10.18/± 0.79cm (m). The length from the most cranial point to the distal tendon (cTPMdT) is 7.90/± 0.43cm (f) and 9.79/± 1.11cm (m).

Conclusions This study gives basic information about the temporalis muscle and its anatomy to support existing and future surgical procedures in their performance. The recommended minimum length of FL to perform a temporalis muscle transfer with FLA is 7.03cm for female and 5.99cm for male, and minimum width of 3 cm. We recommend harvesting some extra centimeters to allow adjusting afterward.

Keywords

facial palsy - temporalis muscle - lengthening temporalis myoplasty - fascia lata augmentation

Patient Consent

In this study, we investigated the surgical anatomy of cadaver donors. The cadaver donors provided their consent in their lifetime that their bodies may be used for scientific purposes.


Ethical Approval

This study has been ethical approved by the ethical committee (IRB) of the Medical University of Vienna with the EK Nr. 1463/2018.


Authors' Contributions

Y.Z. was involved in conceptualization, data curation, formal analysis, investigation, methodology, visualization, and writing --original draft. J.S. contributed to conceptualization, investigation, methodology, and writing –review and editing. W.J.W., U.M.H., and L.R. helped in providing resources. ErdemYildiz helped in investigation. C.H.J.T. contributed to conceptualization, investigation, methodology, project administration, supervision, and writing –review and editing.


Presentation History

WRSM 2019


50th Annual meeting of the German Society of Plastic, Reconstructive and Aesthetic Surgery


58th Annual Meeting of the Austrian Society of Plastic, Aesthetic and Reconstructive Surgery


DAM 2021 (German speaking-group for Microsurgery)




Publication History

Received: 03 April 2022

Accepted: 12 August 2022

Article published online:
06 February 2023

© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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