Boahene Kofi D, Farrag Tarik Y, Ishii Lisa, Byrne Patrick J
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St, Sixth Floor, Baltimore, MD 21287-0910, USA.
Arch Facial Plast Surg. 2011 Jan-Feb;13(1):8-13. doi: 10.1001/archfacial.2010.100.
To describe a minimally invasive approach of the temporalis tendon transposition technique for dynamic reanimation in patients with long-standing facial paralysis.
We report a case series of 17 consecutive patients with facial paralysis who underwent minimally invasive temporalis tendon transposition surgery for dynamic facial reanimation between January 1, 2006, and December 31, 2008. The minimally invasive technique is described. Preoperative and postoperative records, photographs, and videos were reviewed for feasibility of the technique, symmetry, oral competence, and dynamic oral commissure movement.
All the patients tolerated the procedure well, and none developed procedure-related complications. All the patients achieved improved symmetry at rest and voluntary motion of the oral commissure. In all the patients, the temporalis tendon was transposed to the modiolus without the need for fascial extension or lengthening myoplasty.
The temporalis tendon can be transposed for immediate dynamic reanimation of the paralyzed lower face using a minimally invasive approach. This procedure involves a single small incision and minimal dissection, with no major osteotomies. Acquisition of desired facial movement requires intensive physiotherapy and a motivated patient.
描述一种用于长期面瘫患者动态面部重建的颞肌腱转位微创技术。
我们报告了一组连续17例面瘫患者的病例系列，这些患者在2006年1月1日至2008年12月31日期间接受了微创颞肌腱转位手术以进行动态面部重建。描述了该微创技术。回顾术前和术后记录、照片及视频，以评估该技术的可行性、对称性、口腔功能以及口角动态运动情况。
所有患者对手术耐受性良好，均未出现与手术相关的并发症。所有患者在静息状态和口角自主运动时的对称性均得到改善。所有患者的颞肌腱均转位至口角，无需筋膜延伸或延长肌成形术。
使用微创方法可将颞肌腱转位用于立即动态重建瘫痪的下半面部。该手术只需一个小切口和最少的解剖操作，无需进行大的截骨术。获得理想的面部运动需要强化物理治疗和患者的积极配合。
