Evaluación cefalométrica y electromiográfica de niños y niñas con incompetencia labial y anomalías dentomaxilares

Objetivo: Describir las características craneofaciales, dentoalveolares, de tejido blando, vía aérea y el patrón de actividad muscular determinadas a través de los estudios cefalométricos y electromiográficos de individuos incompetentes labiales y con presencia de anomalías dentomaxilares de 7 a 12 años de edad. Materiales y método: Cuarenta y seis participantes con incompetencia labial fueron sometidos a una toma de radiografía lateral de perfil para el análisis cefalométrico. Para el estudio electromiográfico se consideró el patrón de actividad de los músculos Orbicular superior de los labios, orbicular inferior de los labios y temporal anterior en funciones: reposo, fonoarticulación, deglución, máximo apriete labial. Resultados: Se observó clase II esqueletal y molar, retrusión mandibular, biprotrusión incisal, biprotrusión labial, disminución de vía aérea superior. La mayor actividad muscular fue observada en máximo apriete labial. Conclusión: Los niños y niñas con incompetencia labial y anomalías dentomaxilares presentan alteraciones en las características craneofaciales, dentoalveolares, de tejido blando, vía aérea y actividad muscular determinadas a través de los estudios cefalométricos y electromiográficos.

Objective: To describe craniofacial, dentoalveolar, soft issue and airway features, and the muscular activity, determined through a cephalometric and electromyographic study in individuals with lip incompetence and dentomaxillary anomalies aged 7 to 12 years. Methods: Forty-six participants with lip incompetence underwent lateral profile radiography for cephalometric analysis. For the electromyographic study, the activity of the superior orbicularis oris, inferior orbicularis oris and anterior temporalis muscles was considered in the following functions: rest, speaking, swallowing, and reciprocal compression of the lips. Results: Skeletal and molar class II, mandibular retrusion, labial biprotrusion, incisal biprotrusion, and upper airway dysfunction were found. The highest muscular activity was observed in reciprocal compression of the lips. Conclusion: Children with lip incompetence and dentomaxillary anomalies have alterations in the craniofacial, dentoalveolar, soft issue, and airway features, and in the muscular activity , determined through a cephalometric and electromyographic study.

mRNA expression of myosin heavy chain isoforms in the sphenomandibularis portion of the temporalis muscle / Expresión de ARNm de las isoformas de la cadena pesada de la miosina en la porción esfenomandibular del músculo temporal

SUMMARY: The main objective of this study was to analyze by real-time quantitative polymerase chain reaction (RT-qPCR) the expression patterns of the myosin heavy chain (MHC) isoforms (MHC-I, MHC-IIa, MHC-IIx) in the sphenomandibularis portion of the temporalis muscle. We expected to find differences between the sphenomandibularis and the other portions of the temporalis that could be related to the functional characteristics of the sphenomandibularis identified by electromyography. We dissected the right temporalis muscle of ten adult human individuals (five men and five women). Samples of the anterior and posterior temporalis and of the sphenomandibularis portion were obtained from each dissected muscle. These samples were analyzed by RT-qPCR to determine the percentages of expression of the MHC-I, MHC-IIa and MHC-IIx isoforms. No significant differences were identified between the anterior and the posterior temporalis in the expression patterns of the MHC-I, MHC-IIa and MHC-IIx isoforms. However, there were significant differences between the sphenomandibularis and the anterior temporalis. Specifically, the sphenomandibularis portion had a higher percentage of expression of the MHC-I isoform (P=0.04) and a lower percentage of expression of the MHC-IIx isoform (P=0.003). The pattern of expression that we observed in the sphenomandibularis reflects a greater resistance to fatigue, a lower contraction speed, and a lower capacity of force generation in the sphenomandibularis compared to the anterior temporalis. These characteristics are consistent with electromyographic findings on the functional differences between these two portions.

RESUMEN: El principal objetivo de este estudio fue analizar mediante real-time quantitative polymerase chain reaction (RT-qPCR) los patrones de expresión de las isoformas de la cadena pesada de la miosina (MHC-I, MHC-IIa y MHC-IIx) en la porción esfenomandibular del músculo temporal. Se esperó encontrar diferencias entre el esfenomandibular y las otras porciones del músculo temporal que se pudieran relacionar con las características funcionales del esfenomandibular, identificadas mediante electromiografía. Para obtener estos resultados, se diseccionó el músculo temporal derecho en diez humanos adultos (cinco hombres y cinco mujeres) y se obtuvieron muestras de la porción anterior y posterior del músculo temporal y de su porción esfenomandibular. Estas muestras fueron analizadas mediante RT-qPCR para determinar los porcentajes de expresión de las isoformas MHC-I, MHC- IIa y MHC-IIx. No se identificaron diferencias significativas de los patrones de expresión entre la porción anterior y la porción posterior del músculo temporal, pero sí que se observaron diferencias significativas entre la porción anterior del músculo temporal y su porción esfenomandibular. Concretamente, la porción esfenomandibular presentó un mayor porcentaje de expresión de la isoforma MHC-I (P=0.04) y un menor porcentaje de expresión de la isoforma MHC-IIx (P=0.003). El patrón de expresión que hemos observado en la porción esfenomandibular del músculo temporal refleja una mayor resistencia a la fatiga, una velocidad de contracción más lenta y una menor capacidad de generar fuerza si se compara esta porción con la porción anterior del músclo temporal. Estas características son consistentes con las diferencias funcionales que presentan estas dos porciones, que han sido descritas mediante electromiografía.

Prompt value of MRI scanner-detected temporalis muscle thickness in patients with stroke / 中华老年医学杂志

Objective:To investigate the relationship of sarcopenia diagnosed by temporalis muscle thickness(TMT)with physical status and prognosis of stroke patients.Methods:Temporalis muscle thickness was detected by MRI scanner.The median value of TMT was used as the risk classification index of sarcopenia in 265 stroke patients.The relationships of TMT with several indicators of Essen Stroke Risk Score(ESRS), National Institutes of Health Stroke Scale(NIHSS), Barthel index, water swallow test, Venous thromboembolism(VTE)assessment of medical inpatients, as well as the modified Rankin Score(mRS)follow-up results at 3 and 6 months after discharge were retrospectively analyzed.Results:There were 166 men and 99 women in the study cohort, with an average age of(62±13.1)years.The TMT value of men was 0.58 mm, which was significantly higher than that of women( t=2.307, P<0.05).There were significant differences in age( χ2=33.443, P<0.001), albumin( t=-2.467, P<0.05), triglyceride( Z=-2.777, P<0.01)and hemoglobin( t=-3.264, P<0.001)between sarcopenia group and non-sarcopenia group.As compared with non-sarcopenia group, atherosclerosis( χ2=4.715, P<0.05), pulmonary infection( χ2=4.707, P<0.05)and hypertension( χ2=4.046, P<0.05)were easy to be accompanied in sarcopenia group.There was good agreement in TMT measurements among different investigators(ICC=0.980, P<0.001).After adjusting for confounding variables, Logistic regression analysis showed that sarcopenia was significantly correlated with ESRS( OR=1.92, P< 0.05)and Barthel index( OR=1.66, P< 0.05)at admission, and Barthel index after discharge( OR=1.84, P<0.05), mRS at 3 months after discharge( OR=3.09, P<0.001), mRS at 6 months after discharge( OR=3.36, P<0.001). Conclusions:TMT can be used as a comprehensive index to dynamically display the physical state and prognosis of stroke patients, but further research is needed to determine the causal relationship.

Establishment of Endoscopic Surgical Innovative System of Recurrent Nasopharyngeal Carcinoma / 肿瘤防治研究

Nasopharyngeal carcinoma (NPC) is a common malignant tumor in China. Radiotherapy is the first-line treatment. After appropriate radiotherapy, about 5%-15% patients experience recurrence. In view of the poor efficacy and high incidence of severe late toxicities associated with re-irradiation, salvage surgery by the transnasal endoscopic approach is recommended for recurrent NPC (rNPC). Compared with re-irradiation, endoscopic surgery can better prolong survival, improve the quality of life, and reduce complications and medical expenses of patients with rNPC. However, the complexity of the nasopharyngeal skull base enhances the difficulty and risk of surgery. Expanding the boundary of surgical resection remains a clinical challenge for otolaryngologists. In this regard, to help more advanced patients with rNPC, the surgical innovative system of NPC needs to be established by multi-disciplinary cooperation, involving skull base anatomy-based investigation, appropriate administration of the internal carotid artery (ICA), repair of skull base defect, and establishment of various types of endoscopic endonasal nasopharyngectomy.

Reconstrucción de cavidad oral con colgajo de músculo temporal: caso clínico / Reconstruction of oral cavity with temporal muscle flap: a clinical case

Objetivo: Describir la técnica de reconstrucción oral con colgajo de músculo temporal por resección de lesión oncológica. Caso clínico: Un paciente de sexo masculino, de 70 años de edad, fue derivado al Hospital Sirio Libanés desde la Facultad de Odontología de la Universidad de Buenos Aires con diagnóstico de carcinoma mucoepidermoide de siete meses de evolución, ubicado en el reborde alveolar del maxilar superior izquierdo, a nivel de las piezas dentarias 25 a 28. Se realizó la resección del tumor bajo anestesia general y la consiguiente reconstrucción del lecho mediante la técnica de reconstrucción oral con colgajo de músculo temporal. Conclusión: El colgajo temporomiofascial resultó ser versátil para la reconstrucción maxilofacial en lo que respecta a la proximidad, el tamaño, la fiabilidad de la vascularización y la facilidad de la técnica (AU)

Aim: To describe the temporalis myofacial flap technique for reconstruction in the maxillofacial region following oral cancer resection. Clinical case: A 70-year-old male patient was referred to the Sirio Libanés Hospital from the Dental School, University of Buenos Aires with a diagnosis of mucoepidermoid carcinoma with 7 months of evolution located in the alveolar ridge of the left upper jaw, at the level of teeth 25 to 28. The tumor was resected under general anesthesia and a rotational flap of the temporalis muscle was used for the reconstruction of the area. Conclusion: The temporalis flap was a versatile option for the reconstruction of maxillofacial defects due to its proximity to the oral cavity, the reliable vascularity and minor donor site morbidity (AU)

Interpositional arthroplasty with temporalis myofascial flap reconstruction in a case of temporomandibular joint bony ankylosis: a case report and review of literature

The report describes the treatment of a 30 year old female patient having unilateral right temporomandibular joint (TMJ) bony ankylosis whose mouth opening was restricted to 5 mm and had additional mandibular retrognathism causing severe mastication problems besides speech difficulties and low morale. The ankylosis had resulted in facial asymmetry due to bony hard swelling in front of right tragus. The patient was taken up for right interpositional arthroplasty with temporalis myofascial flap reconstruction by pre auricular approach and left coronoidectomy by intraoral approach as a preferred technique. A satisfactory mouth opening of 33 mm was achieved in immediate post-operative. Patient was followed up with aggressive mouth opening exercises in postoperative period.

Colgajo temporal en la reconstrucción de un defecto maxilar por exéresis de carcinoma ameloblástico / Temporalis muscle flap in the reconstruction of a maxillary defect caused by exeresis of ameloblastic carcinoma

RESUMEN Introducción: El carcinoma ameloblástico es una entidad rara que surge como una neoplasia primaria o a partir de un ameloblastoma preexistente. El colgajo de músculo temporal es una opción terapéutica frecuentemente empleada para la reconstrucción del defecto resultante luego de la exéresis quirúrgica. Objetivo: Presentar un caso clínico de restauración estética y funcional mediante reconstrucción con colgajo temporal de un defecto maxilar por exéresis de carcinoma ameloblástico, dada la infrecuente presentación de esta entidad. Caso clínico: Mujer de 49 años de edad, que refiere "una bola" en el paladar de 9 meses de evolución. Al examen físico facial presenta aumento de volumen en región infraorbitaria izquierda. Se realizó una tomografía axial computarizada en la que se constató la presencia de imagen hiperdensa en seno maxilar izquierdo con calcificación en su interior, produciendo lisis del hueso nasal y hueso cigomático infiltrando partes blandas. Se tomó muestra para biopsia que informó tumor de alto grado de malignidad correspondiente a carcinoma ameloblástico. En estudio radiográfico de tórax no se apreció presencia de metástasis pulmonar. Se realizó maxilarectomía de infra y mesoestructura, resección de la lesión con margen oncológico de seguridad y se reconstruyó el defecto palatino con colgajo pediculado del músculo temporal. Se indicó quimio y radioterapia como terapia adyuvante al tratamiento quirúrgico. Se mantuvo el chequeo posoperatorio mostrándose buena evolución clínica y una epitelización secundaria del músculo temporal en el área palatina con restauración de las funciones. Conclusiones: Se presentó un caso clínico de carcinoma ameloblástico, entidad patológica de escasa frecuencia. La cirugía constituyó el pilar de tratamiento utilizado. Una vez realizada la resección quirúrgica se reconstruyó el defecto palatino, utilizándose el colgajo del músculo temporal, opción útil para lograr el restablecimiento de las funciones estéticas y funcionales como la deglución y fonación(AU)

ABSTRACT Introduction: Ameloblastic carcinoma is a rare condition emerging as a primary neoplasm or from a preexisting ameloblastoma. Temporalis muscle flap is a therapeutic option frequently used for reconstruction of the defect resulting from surgical exeresis. Objective: Present a clinical case of esthetic and functional restoration by reconstruction with temporalis muscle flap of a maxillary defect caused by exeresis of an ameloblastic carcinoma. The case is presented because of the infrequent occurrence of this condition. Clinical case: A female 49-year-old patient reports "a lump" in her palate of nine months evolution. Physical examination finds an increase in volume in the left infraorbital region. Computed axial tomography was indicated, which revealed the presence of a hyperdense image in the left maxillary sinus with internal calcification causing lysis of the nasal bone and the zygomatic bone, and infiltrating soft tissue. A sample was taken for biopsy, which reported a tumor with a high degree of malignancy corresponding to ameloblastic carcinoma. Chest radiography did not show the presence of lung metastasis. Infra- and mesostructure maxillectomy was performed, the lesion was removed with a surgical safety margin, and the palatine defect was reconstructed with a pediculated temporalis muscle flap. Chemo- and radiotherapy were indicated as adjuvants to the surgical treatment. Postoperative follow-up found good clinical evolution and secondary epithelization of the temporalis muscle in the palatine area with restoration of functions. Conclusions: A clinical case was presented of ameloblastic carcinoma, a condition with a low frequency of occurrence. Surgery was the basic component of the treatment applied. Once surgical resection was performed, the palatine defect was reconstructed by means of a temporalis muscle flap, a useful option to achieve the restoration of esthetic and biological functions, such as swallowing and speech(AU)

Comparisons of Results of Type 1 Tympanoplasty Using Temporalis Fascia and Tragal Perichondrium: A Prospective Study

Introduction: Type 1 tympanoplasty is one of the commonest operations done by an ENT surgeon. There are a number of choices regarding the graft material that one uses in this operation. Among those, temporalis fascia and tragal perichondrium are the most common. The aim of the study was to compare the results of tympanoplasty between two groups of patients- one using temporalis fascia as the graft material and the other using tragal perichondrium. Material and methods: This prospective study group consisted of 46 patients between the ages of 10 to 49 years. Only patients with dry safe central perforations and pure conductive hearing loss were included. Success was defined as ear-drum closure with no residual perforation. Hearing improvement was defined as air-bone gap less than 10dB. Results: We had included 46 patients in our study. Of them, 23 had tympanoplasty with temporalis fascia and the other 23 had tympanoplasty with tragal perichondrium. Conclusion: The study showed that both temporalis fascia and tragal perichondrium gave more or less the same results with regard to successful drum closure and hearing improvementthere was little to choose between these two

​Outcome Of Type 1 Tympanoplasty With Cartilage-Perichondrium Graft In Comparison With Temporalis Fascia

OBJECTIVE: To compared the outcome of Type 1 tympanoplasty with cartilage-perichondrium graft in comparison with temporalisfascia graft in terms of post-operative graft take-up and hearing results.MATERIALS AND METHODS: A prospective observational study among 80 patients between 15 and 60 years of age satisfyingthe inclusion criteria with complaints of ear discharge and hearing loss due to COM - mucosal type was conducted. Patientswere grouped in two groups of 40 patients each. Group A patients underwent Type 1 tympanoplasty with temporalis fasciaand Group B with cartilage-perichondrium graft. Patients were followed up for graft uptake, hearing improvement and rate offailure are compared for both the grafts. Graft uptake was assessed at the end of the 1st month, 3rd month, and 6th month,and hearing was assessed at the end of the 6th month with pure tone audiometry.RESULTS: Patients with temporalis fascia graft showed a take-up rate of 80% and cartilage-perichondrium graft of 92.5% by6 months. Among the fascia group, graft failure was seen in 20% (8). One patient had failed take-up of graft and four patientsshowed reperforation. In cartilage group, three patients showed failure of take-up of graft during the 1st month. No patient hadreperforation or retraction. Air-bone gap in fascia group showed a closure to 10 dB in 17.5% (7). In the cartilage group, 10 dBin 25% (10 patient s). In our short-term follow-up of 6 months, we found that cartilage-perichondrial graft reduces the chanceof reperforation and retraction even with variation in middle ear pressure due to eustachian tube catarrh. It gives good takeup rate and comparable hearing result as that of the fascia graft. It does not affect the sound conduction when thinned outto appropriate thickness. It is available from the same surgical field and in sufficient quantity for the closure of the TM defect.Cartilage-perichondrium graft for Type 1 tympanoplasty could be a successful replacement for temporalis fascia giving goodresult with neotympanum.

Functional Restoration by Interpositional Arthroplasty with Temporalis Myofascial Flap in Temporomandibular Joint Ankylosis - A Clinical Study

Purpose: The purpose of this clinical study was to evaluate the functional restoration by interpositional arthroplasty with temporalis myofascial flap in temporomandibular joint ankylosis. Methods: After obtaining consent, the procedure were explained to the patient and each of the patients who met the inclusion criteria of the present study were randomly selected. Preoperatively all required investigations were done, fitness opinion for surgery and general anaesthesia was obtained, preoperative mouth opening / interincisal distance was measured with calliper, occlusion recorded, and midline shift was assessed. Surgical procedure (interpositional arthroplasty with temporalis myofascial flap) was carried out under general anaesthesia with endotracheal intubation. And patient was followed for about six months and following parameters were recorded. Mouth opening / interincisal distance, occlusion, Midline shift, Pain and Diet (solid/liquid). Results: In the present study, the temporalis myofascial flap was evaluated to be efficient in preventing the reankylosis. Preoperatively the mean interincisal opening was 6.93mm and post-operatively after a period of 6 months follow-up it remained as 34.93mm. Conclusion: The temporalis myofascial flap is an efficient interpositional material. It is a biologic, autogenous tissue, so there is no question of any rejection. The results of this study indicate that the use of temporalis muscle and fascia flap is effective in treating TMJ ankylosis.

Maximum Decompressive Hemicraniectomy for Patients with Malignant Hemispheric Infarction

OBJECTIVE: The authors applied maximum external decompression for malignant hemispheric infarction and investigated the functional outcome according to the patient age.METHODS: Twenty-five patients with malignant hemispheric infarction were treated using a hemicraniectomy with maximum external decompression, comprising a larger (>14cm) hemicraniectomy, resection of the temporalis muscle and its fascia, spaciously expansive duraplasty, and approximation of the skin flap. The medical and diagnostic imaging records for the patients were reviewed, and 1-year functional outcome data obtained for the younger group (aged ≤ 60 years) and elderly group (aged > 60 years).RESULTS: The patients (n=25) who underwent maximum surgical decompression revealed a minimal mortality rate (n=2, 8.0%). The patients (n=14) in the younger group all survived with mRS scores of 2 (n=1, 7.1%), 3 (n=7, 50.0%), 4 (n=3, 21.4%), or 5 (n=3, 21.4%). A majority of the younger patients (57.1% with mRS ≤3) lived with functional independence. When the 1-year mRS scores were dichotomized between favorable (mRS ≤3) and unfavorable (mRS ≥4) outcomes, the younger group had significantly more patients with a favorable outcome than the elderly group (57.1% versus 9.1%, p=0.033). In contrast, in the elderly group, most patients showed unfavorable outcomes with the mRS scores of 4 (n=5, 45.5%), 5 (n=3, 27.3%), or 6 (n=2, 18.2%), whereas only one patient showed favorable outcome (mRS 3). A majority of the elderly patients (45.5% with mRS 4) survived with moderately severe disability.CONCLUSION: For malignant hemispheric infarction, a hemicraniectomy with maximum external decompression was found to considerably increase survival with a favorable outcome in functional independence (mRS ≤3) for younger patients aged ≤60 years. It can be optimal surgical treatment for younger patients.

Repair of Nasal Septal Perforation Using Polycaprolactone Plate and Temporalis Fascia Graft

Comparison between clinical and audiological results of tympanoplasty with modified sandwich technique and underlay technique / Comparação entre os resultados clínicos e audiológicos de timpanoplastia com a técnica "sanduíche" modificada e a técnica underlay

Abstract Introduction: Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich tympanoplasty is the combined overlay and underlay grafting of tympanic membrane. Objective: To describe and evaluate the modified sandwich graft (mediolateral graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty. Methods: A total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay technique. We assessed the healing and hearing results. Results: Successful graft take up was accomplished in 47 patients (97.9%) in Group A and in 40 patients (83.3%) Group B. The average Air-Bone gap closure achieved in Group A was 24.4 ± 1.7 dB while in Group B; it was 22.5 ± 3.5 dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant. Conclusion: Double layered graft with drum-malleus as a 'meat' of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity.

Resumo Introdução: O reparo cirúrgico da membrana timpânica, denominado timpanoplastia tipo 1, é uma modalidade de tratamento já bem estabelecida. As técnicas overlay ou underlay de timpanoplastia são comuns. A timpanoplastia "sanduíche" é a técnica de enxerto de membrana timpânica overlay e underlay combinadas. Objetivo: Descrever e avaliar a timpanoplastia com a técnica "sanduíche" modificada (timpanoplastia mediolateral) utilizando fáscia temporal e fáscia aureolar. Comparar o desfecho clínico e audiológico da timpanoplastia com a técnica "sanduíche" modificada com o da timpanoplastia com a técnica underlay. Método: Foram estudados 88 pacientes com otite média crônica, 48 (Grupo A) foram submetidos à timpanoplastia tipo 1 com enxerto "sanduíche" modificado. A fáscia temporal foi utilizada na técnica underlay e a fáscia areolar na técnica overlay. 48 pacientes (Grupo B) foram submetidos à timpanoplastia tipo 1 com a técnica underlay. Foram avaliados os resultados da cicatrização e da audição. Resultados: O sucesso do enxerto ocorreu em 47 pacientes (97,9%) no Grupo A e em 40 (83,3%) do Grupo B. O fechamento médio do gap aéreo-ósseo no Grupo A foi de 24,4 ± 1,7 dB, enquanto no Grupo B foi de 22,5 ± 3,5 dB. Houve diferença estatisticamente significativa na taxa de cicatrização do enxerto. A diferença na melhora auditiva não foi estatisticamente significante. Conclusão: O enxerto de camada dupla e o tímpano-martelo posicionados como o "recheio" do sanduíche mantém um equilíbrio perfeito entre a estabilidade necessária e adequada sensibilidade acústica.

To Compare The Study Of The Effectiveness Of The Use Of Tragal Cartilage With Temporalis Fascia In Tympanoplasty

Background: Hearing is a sense that enables man to establish contact with his fellows via speech to experience life more fully. Deafness in varying degrees of severity is a big impediment to the integration of a person into the social structure. The otologist in the past had not much to offer to hearing handicapped people with chronic middle ear disease. With recent times the advent of the antibiotic era, the operating microscope and modern anesthetics techniques aimed at producing a dry, magnified operating field, have radically altered the outlook. Methods: This Prospective Randomised Comparative Study comprises of patients who were subjected to tympanoplasty for the treatment of chronic suppurative otits media. Each patient was subjected to a detail examination of nose, paranasal sinuses and throat to rule out any focus of infection, which could influence the result of tympanoplasty. 35 Patients were subjected to tympanoplasty with temporalis fascia while the remaining 35 patients underwent with tragal perichondrium in the age group of 15-50 years (males and females both ). Patients with the complaint of discharging ear and decreased hearing were also screened . Results: Majority of the patients preoperatively showed mild to moderate hearing loss.45.7% patients showed upto 20 db air bone gap range, 48.5% patients being in 21-40db air-bone gap and only 5.7% patients is above 40db. Graft take rate was overall 78.5%. Take-rate was 80% with temporalis fascia and 77.1% with tragal perichondrium. In the postoperative hearing analysis, 75.7% of the patients showed air- bone gap upto 20dB. 21.4% of the patients showed air- bone gap in the range of 21-40 Db. Mean improvement in hearing for temporalis fascia was 12.8 db and for tragal perichondrium was 11.4 db. Take rate of graft was not influenced by the size of perforation. Improvement in hearing was also not significantly influenced by the type of graft used. Conclusion: Tympanoplasty is the most effective method for control of the tubotympanic type of CSOM disease and hearing improvement. Both temporalis fascia and tragal perichondrium are excellent graft materials for closure of perforation of tympanic membrane and hearing improvement. Graft uptake rate is good for both with slightly better take rates for temporalis fascia, than tragal perichondrium.Improvement in hearing is not significantly influenced by duration of disease, age or sex of patients site or size of perforation

Small incision through the tragus for the treatment of sagittal condylar fracture / 口腔疾病防治

Objective@#The purpose of this study was to a new operative approach for sagittal condylar fractures via a preauricular small incision-based technique and to examine the effectiveness of this approach. @*Methods@#Fifteen patients (19 sides) with sagittal condylar fractures were included in the study. The incision length was approximately 4 cm through the tragus, exposing the superficial temporal vessels, which was then pulled forward. Next, the deep temporal superficial fascia was cut, and the surface of the zygomatic arch and the articular capsule of the temporomandibular joint were exposed. Joint capsule incision was performed, with mandibular condylar fracture fixation under direct vision. We followed up with the patients postoperatively for 6 months with clinical and radiographic examinations. @*Results @#All patients had 1 week postoperation before being discharged, during which 2 cases of mild facial paralysis (with lateral temporal level Ⅱ facial paralysis, with lateral temporal branch level Ⅲ facial paralysis and level Ⅱ zygomatic branch of facial nerve paralysis after treatment) were observed, after given nerve nutrition agents, 2 cases returned to normal within 3 months. No patient exhibited a postoperative delayed fistula infection or other serious complications. Intraoperative occlusion relationships recovered well, and postoperative CTs suggested that the fracture ends and condyles were in good condition. The occlusion relationship was normal for 3 months after surgery, with a degree of opening greater than 30 mm, no play in the joints and no oblique openings being observed, and reexamination 6 months after the surgery revealed no obvious scars.@*Conclusion@#This surgical method involves a small incision and clear anatomic structures and avoids damage to the facial nerve. This method provides better surgical vision for treatment of sagittal condylar fractures, is safe and convenient, and deserves clinical recommendation.

Management of the paralyzed face using temporalis tendon transfer via intraoral and transcutaneous approach / 대한악안면성형재건외과학회지

Temporalis tendon transfer is a technique for dynamic facial reanimation. Since its inception, nearly 80 years ago, it has undergone a wealth of innovation to produce the modern operation. Temporalis tendon transfer is a relatively minimally invasive technique for the dynamic reanimation of the paralyzed face. This technique can produce significant and appropriate movement of the lateral oral commissure, more closely mimicking the normal side. The aim of this article is to review the technique of temporalis tendon transfer involving transferring of the coronoid process of the mandible with the insertion of the temporalis tendon via intra-oral and transcutaneous approach.

Clinical practicability and safty of the filler injective plane of posterior temporalis myofascia space for temporal hollows / 中华医学美学美容杂志

Objective To introduce our clinical method of filler injection with the posterior space of temporalis myofascia for temporal hollows,and to discuss the practical practicability,safety and aesthetic outcomes.Methods From Jan.2014 to Jan.2016,female patients with temporal hollows who had underwent the filler injecting into the posterior space of temporalis myofascia were involved in our study.The patients with previous history of surgery or trauma on temporal region were excluded.Hyaluronic acid or autologous fat was selected as filler material based on patients' preference.Then,aesthetic outcomes were followed up.120 cases were selected in this study.Among them,52 cases preferred hyaluronic acid,and the average follow-up time was 7.5 months.68 cases acceped autologous fat grafting with average follow-up for 9.5 months.Results All patients got aesthetic and safe outcome.No serious complications were noted,such as infection,embolism,uneven appearance and so on.The satisfactory rate was high in both patients and surgeons.Conclusions The posterior temporalis myofascia space that is relatively closed,stable,lack of vessels has proved to be the safe plane for temporal injection.Not only our injection method could meet the need for injection procedure safety,but also it could ensure the aesthetic outcomes.In clinical practice,the aesthetic surgeons should be well familiar with the temporal anatomy.

A study on the outcome of tympanoplasty with various graft materials

Background: Chronic Suppurative Otitis Media (CSOM) is one of the most common causes of preventable hearing loss especially in developing countries CSOM is a disease condition characterized by persistent perforation of tympanic membrane with recurrent or persistent mucopurulent Otorrhoea Aim: This study was undertaken to review the outcomes (hearing improvement) achieved by using various graft materials like temporalis fascia (TF), tragal cartilage (TC), Conchal cartilage (CC), autologous sculpted incus (I), autologous cortical bone (BG) in tympanoplasty surgery Material and methods: This study comprised of 14 males and 16 females patients with age ranging from 12 years to 55 years They were selected for surgery after adequate history taking, clinical, otoscopic and microscopic examination Type 1 tympanoplasty was done in 19 patients, Type 3 tympanoplasty + Modified Radical Mastoidectomy (MRM) was done in 11 patients by using various graft materials The results were evaluated in the form of rate of graft success, hearing gain, and the pre and post-operative Air Bone gap Results: Out of 30 patients, in 20 TF graft patients AB gap improvement seen in 14 patients, 5 patients did not show any change and 1 patient did not come for follow up In 2 TC graft patients, both showed improvement in AB gap In 1 patient where CC graft was used showed improvement in AB gap In 6 patients I graft was used, 2 patients showed improvement, 2 patients did not show any change, 1 patient did not come for follow up and in 1 patient AB gap worsened In 1 patient BG was used and no change in AB gap was seen Out of 30 cases graft uptake was seen in 25 cases and graft rejection was seen in 3 cases and 2 patients did not come for follow up Graft rejection was documented in one case where TF was used, one case where incus graft was used and in another case where BG was used Harinarayana N, Srikanth M A study on the outcome of tympanoplasty with various graft materials IAIM, 2018; 5(12): 77- 82 Page 78 Conclusion: Post-operative hearing gain obtained was found to be better in patients operated upon with tubotympanic disease than those operated upon with atticoantral disease The post-operative hearing improvement depends not only on the graft material used and the type of tympanoplasty but also on the pre-operative status of the ossicular chain

Proposal of surface electromyography signal acquisition protocols for masseter and temporalis muscles

Abstract Introduction The aim of this study was to propose a method of electrodes positioning on the superficial masseter and anterior temporalis muscles for surface electromyographic (sEMG) recordings in order to overcome some known methodological constraints. Methods Fifteen volunteers with normal occlusion participated in two experimental sessions within a 7 day-period. Surface electrodes were placed on two different locations that were based on palpable and individual anatomical references. Surface EMG signals (2000 Hz per channel; A/D: 16 bits; gain: 2000 X; band-pass filter: 20-500 Hz) were recorded under three conditions: mandibular rest position, 30% and 100% of maximum voluntary bite force. Three measurements of maximal bite force were taken by using a force transducer positioned over the lower right first molar region and the highest record was taken into account. The root mean square value was considered for analysis. Intraclass correlation coefficients (ICCs), paired t test, and the Bland-Altman method comprised the statistical analyses. The level of significance was set at 0.05. Results ICC records for right and left masseter and anterior temporalis muscles at T0 (first sEMG record) and T7 (second sEMG record) intervals were significantly different (p<0.05). The results showed satisfactory to excellent reproducibility of RMS values at rest, MVBF and 30% MVBF, as well as for MVBF in kgf. Conclusion The results showed reliable reproducibility for the sEMG signal recording in masseter and anterior temporalis muscles from the protocols presented and under the three conditions investigated.

Clinical analysis of curative effect of acellular dermal matrix contrast with temporalis fascia in type Ⅰ tympanoplasty / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the clinical curative effect of acellular dermal matrix contrast with temporalis fascia in type Ⅰ tympanoplasty. METHODS A retrospective analysis of 60 inflammatory chronic suppurative otitis media patients from January 2014 to January 2015 in Genenral Hospital of PLA Guangzhou Military Area were conducted.All cases were perpormed the ear incision under local anesthesia, including 32 cases(32 ears) with acellular dermal matrix, 28 cases(28 ears) with temporal fascia. The operation time, postoperative pain, the healing of tympanic membrane and the postoperative recovery were compared between the two groups. RESULTS There was significant difference in the operation time and postoperative pain between the two groups(P0.05). CONCLUSION The effect of acellular dermal matrix for repairing tympanic membrane is similar to the temporalis fascia. The use of acellular dermal matrix has the advantage of shorter operation time, less postoperative pain, and can avoid regional two incisions, it is worthy of clinical application.