Choudhary Sunil, Khanna Soumya, Mantri Raghav, Arora Prateek
From the Max Institute of Reconstructive Aesthetic Cleft and Craniofacial Surgery, Max Super Specialty Hospital, Saket New Delhi, India.
Ann Plast Surg. 2020 Aug;85(2):149-157. doi: 10.1097/SAP.0000000000002266.
Suprazygomatic aponeurotic McLaughlin (SAM) myoplasty technique for facial reanimation is based on the classical McLauglin's lengthening temporalis myoplasty with a series of new modifications. A comprehensive review of previously described other orthodromic temporalis myoplasty techniques is also included to give a succinct comparison.
Twelve adult patients of facial palsy underwent SAM myoplasty for a period of 4 years. Three had congenital facial palsy, 4 patients had facial palsy secondary to acoustic neuromas, 3 were posttraumatic, and 2 patients had Bell's palsy.
Range of modiolus excursion achieved as measured at 3 months postoperatively on reanimation in our patients was 5 mm to 20 mm with an average of 12.6 mm. With SAM myoplasty technique, we were able to achieve excellent result in 4 patients and good results in 8 patients as evaluated with May and Druker scoring system.
Suprazygomatic aponeurotic McLaughlin myoplasty for facial reanimation demonstrates a successful modification of the classical McLaughlin lengthening temporalis myoplasty, making it more customizable, simple, and predictable by taking the level of transection to the temporalis aponeurosis without the need for zygomatic osteotomy. A new classification of orthodromic temporalis myoplasty based on level of transections is also proposed for the first time. Good to excellent outcomes coupled with high patient satisfaction and low morbidity should make this technique popular among the facial reanimation surgeons.
用于面部重建的颧上腱膜麦克劳克林（SAM）肌成形术是基于经典的麦克劳克林颞肌延长肌成形术并进行了一系列新的改良。本文还全面回顾了之前描述的其他顺行性颞肌肌成形术技术，以便进行简要比较。
12例成年面瘫患者接受了SAM肌成形术，为期4年。其中3例为先天性面瘫，4例为听神经瘤继发的面瘫，3例为创伤后面瘫，2例为贝尔面瘫。
术后3个月对患者进行重建时，测得的口角移动范围为5毫米至20毫米，平均为12.6毫米。根据梅和德鲁克评分系统评估，采用SAM肌成形术，4例患者取得了优异效果，8例患者取得了良好效果。
用于面部重建的颧上腱膜麦克劳克林肌成形术证明了对经典麦克劳克林颞肌延长肌成形术的成功改良，通过将颞肌横断水平提升至颞肌腱膜，使其更具可定制性、更简单且可预测，无需进行颧骨截骨术。本文还首次提出了基于横断水平的顺行性颞肌肌成形术新分类。良好至优异的治疗效果、较高的患者满意度和较低的发病率应使该技术在面部重建外科医生中受到欢迎。
