REANIMATION OF THE PARALYZED FACE WITH THE TEMPORALIS MYOFASCIAL FLAP TRANSFER

Purpose: This study presents the “Temporalis myofascial flap transfer technique” in reanimating the
paralyzed face in five patients afflicted with long standing and irreversible facial paralysis. It is an attempt
to highlight the versatility and effectiveness of this method in Facial reanimation of the patient with long
standing and irreversible facial paralysis. A thorough review is presented of the methods and techniques
available to the surgeon and the study underscores the success of the “Temporalis-myofascial flap transfer”
technique in restoring the facial form, function and esthetics of the patient suffering with this debilitating
disorder.
Materials and methods: The study was carried out from June 2002 to Oct 2005. A total of 5 cases were
selected for the study. Four patients were male and one was female. The age range varied from 20 to 42
years with an average age of 31 years. All surgeries were planned under general anesthesia and a standard
protocol was followed for a thorough assessment and evaluation of each case which included a detailed case
history, cinical examination including a general examination and examination of the pathosis i.e., facial
paralysis and pre and post-operative facial photographs.
Results: The results using the temporalis muscle to reanimate the face were recorded as “excellent”, “good”,
“fair” and “poor” for the eye and mouth separately. The results in all five cases were considered excellent
as concerned mouth reanimation and again excellent as concerned eye reanimation in cases 1, 2, 3 and 5.
(Only mouth reanimation was done in case 4 as the eye function and symmetry were normal.)
Conclusion: The results of the temporalis-myofascial / temporalis–myofascial–galeal technique are valid,
reproducible, and highly successful in reanimating the mouth and the eye. We believe that the temporalis
muscle transfer will continue to play an essential role in reanimating the face, particularly for patients with
long-standing facial paralysis. Five cases were successfully treated using the Temporalis muscle fascia/galea
transposition technique for eye and mouth reanimation. One patient was treated for only mouth reanimation
since the eyelid function and eye esthetics were normal.