Chandrasekaran Balamanikandasrinivasan, Rekha M, Neelakandan R S, Gandra Pramod Kumar
Department of Oral and Maxillofacial Surgery, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission Research Foundation- Deemed to be University, Salem, India.
Department of Oral and Maxillofacial Surgery, RVS Dental College and Hospital, Trichy Road, Kannampalayam, Sulur, Coimbatore, 641402 India.
J Maxillofac Oral Surg. 2020 Dec;19(4):571-578. doi: 10.1007/s12663-019-01292-z. Epub 2019 Sep 28.
Facial palsy is a condition where the patients lack voluntary movement on the affected side of the face and are not able to convey their emotions. Besides that, they also succumb themselves to social isolation. Various techniques have been devised to overcome this devastating problem. The aim of this article is to evaluate and compare facial muscle function before and after facial reanimation with temporalis muscle galea pedicled flap by motion mode echomyography in patients with long-standing facial paralysis.
Ten patients with long-standing facial paralysis were included in the study (six patients with LMN palsy and four patients with facial weakness involving specific peripheral branches), and they subsequently underwent facial reanimation surgery with temporalis galea pedicled flap. These patients were followed postoperatively for a period of 1-2 years and were subjectively graded as excellent, good, fair and poor and objectively evaluated by M-mode echomyography, and the results were evaluated and statistically analyzed.
Subjectively, out of 6 patients with LMN palsy, results were graded as excellent in 2 cases, good in 3 cases, fair in 1 case, and out of 4 patients with weakness in specific facial nerve branches, the subjective results were excellent in 2 cases, good in 1 case and fair in 1 case. Objectively, the effect of transposed temporalis galea on orbicularis occuli, levator labii superioris and orbicularis oris was found to be statistically significant in patients with LMN palsy.
Our study proves the versatility of temporalis muscle galea pedicled flap in cases of long-standing facial paralysis by motion mode echomyography.
面瘫是一种患者患侧面部缺乏自主运动且无法表达情感的病症。除此之外，他们还会陷入社会孤立。人们已经设计出各种技术来克服这个严重问题。本文旨在通过运动模式超声肌电图评估和比较长期面瘫患者采用颞肌帽状腱膜蒂瓣进行面部重建前后的面部肌肉功能。
本研究纳入了10例长期面瘫患者（6例下运动神经元性面瘫患者和4例涉及特定周围分支的面部无力患者），随后他们接受了颞肌帽状腱膜蒂瓣面部重建手术。这些患者术后随访1 - 2年，主观上分为优、良、中、差四个等级，并通过M型超声肌电图进行客观评估，对结果进行评估和统计分析。
主观上，6例下运动神经元性面瘫患者中，2例结果评为优，3例评为良，1例评为中；4例特定面神经分支无力患者中，2例主观结果为优，1例为良，1例为中。客观上，在患有下运动神经元性面瘫的患者中，移位的颞肌帽状腱膜对眼轮匝肌、上唇提肌和口轮匝肌的影响具有统计学意义。
我们的研究通过运动模式超声肌电图证明了颞肌帽状腱膜蒂瓣在长期面瘫病例中的多功能性。
