Lengthening Temporalis Myoplasty: Objective Outcomes and Site‐Specific Quality‐of‐Life Assessment

Abstract

Objective Evaluate outcomes of the lengthening temporalis myoplasty in facial reanimations. Study Design Case series with planned data collection. Setting Ospedali Riuniti, Bergamo, and AOUC Careggi, Florence, Italy. Subjects and Methods From 2011 to 2016, 11 patients underwent lengthening temporalis myoplasty; demographic data were collected for each. Pre- and postoperative photographs and videos were recorded and used to measure the smile angle and the excursion of the oral commissure, according to the SMILE system (Scaled Measurements of Improvement in Lip Excursion). All patients were tested with the Facial Disability Index, and they also completed a questionnaire about the adherence to physiotherapy indications. Results All patients demonstrated a significant improvement in functional parameters and in quality of life. On the reanimated side, the mean z-line and a-value, measured when smiling, significantly improved in all patients: from 22.6 mm (95% CI, 20.23-25.05) before surgery to 30.9 mm (95% CI, 27.82-33.99) after surgery ( P < .001) and from 100.5° (95% CI, 93.96°-107.13°) to 111.6° (95% CI, 105.63°-117.64°; P < .001), respectively. The mean postoperative dynamic gain, passing from rest to a full smile at the reanimated side, was 3.1 mm (95% CI, 1.30-4.88) for the z-line and 3.3° (95% CI, 1.26°-5.29°) for the a-value. The Facial Disability Index score increased from a preoperative mean of 33.4 points (95% CI, 28.25-38.66) to 49.9 points (95% CI, 47.21-52.60) postoperatively ( P < .001). Conclusions The lengthening temporalis myoplasty can be successfully used for smile reanimation, with satisfying functional and quality-of-life outcomes.

Twenty-Five-Year Outcomes of Treatment of Irreversible Facial Paralysis with Gillies and McLaughlin Techniques

“…Comparable results have been reported in the literature [7]. The low complication rates described in the literature were confirmed in this study [7, 11-14].…”

Lengthening temporalis myoplasty and reduction of the swallowing oral phase dysfunction in facial palsy patients

“…This is consistent with our study in which LTM increased lip force by a mean of 1.55 times. Panciera et al (18) assessed disability using the Facial Disability Index (FDI) and demonstrated significant improvement in disability, with the FDI score increasing from 33.4 points to 49.9 points i.e. an improvement of 33% (p < 0.001).…”

Dynamic smile reanimation in facial nerve palsy

“…The vertical and horizontal smile symmetry were assessed for each patient. Photographs were initially standardized by comparing white to white iris diameter against the standard human reference value 9 of 11.7 mm to obtain a multiplication factor 10 using Adobe Photoshop CC v20 (Adobe, San Jose, CA, USA). An inter-pupillary line (IPL) was drawn and from the midpoint of the IPL, a perpendicular line was dropped down to the chin point.…”