Facial reanimation by transposition of temporalis muscle

Temporalis muscle transfer to reanimate the face in facial palsy has been well described since early this centmy (Breidahl et aI., 1996). The muscle on the paralyzed side is mobilized from its origin in the temporal area, and transposed through a subcutaneous tunnel to be sutured to the submucosa or perioral muscle using a lip-cheek incision. Many modifications have been instituted that have improved the success and decreased the morbidity ofthis procedure (May and Drucker, 1993). Facial reanimation with the tcmporalis muscle transfer has withstood the test of time and still is a refercnce technique (Gomez et aI., 1998).Mouth asymmetry was noticed, after temporalis muscle transposition using the standard technique, due to stretching of the paralyzed half hetween the llIuscle l{>rce of the healthy side and the transposed lcnlporalis IlIUSCh:, so, to overcomc this stretch, we nlOdilied the standard tcchniquc by creating a subcutancous tunnd in thc uppcr and lowcr lips, to rcach thc contralateral paralllcdian plane, using slips orthc klllporalis 1:lscia.(’olllparison or rcsults, hclwccn the standard techniquc, dcscribed by M~IY ~llld Druc:kcr, 1993, and the modified techniqm:..