EARLY TEMPORALIS MUSCLE TRANSPOSITION FOR THE MANAGEMENT OF FACIAL PARALYSIS

Temporalis muscle transposition is a reliable surgical technique for t he reanimation of patients with long-standing facial paralysis. It is often employed when facial nerve reinnervation via crossover or cable grafting is not possible. Temporalis muscle transposition can also be used for the immediate treatment of complete facial paralysis due to i nsults leaving the facial nerve anatomically intact but requiring a pr olonged recovery time (more than I year). Because temporalis muscle tr ansposition does not interfere with neuronal regeneration, it may be e mployed early in the management of complete facial paralysis when reco very is predicted to be extended and incomplete. The authors report th eir experience with early temporalis muscle transposition in the manag ement of facial paralysis in 56 patients with an anatomically intact f acial nerve. More than 90% of these patients achieved improved symmetr y at rest as well as purposeful movement at the corner of the mouth. I n the last 30 patients, the temporoparietal fascial flap was simultane ously harvested and successfully used to obliterate the donor site def ect. In conjunction with the immediate implantation of a gold weight i n the ipsilateral upper eyelid, this approach to the early management of facial paralysis helps reduce the period of facial disability from years to weeks in a select group of patients.