Reconstrucción de defecto de órbita con colgajo prelaminado de fascia temporal superficial / Orbit defect reconstruction with pre-laminated temporal superficial fascia flap

El colgajo de fascia temporal superficial es muy versátil para la reconstrucción de defectos tisulares localizados en los tercios superior y medio de la cara, en la región orbito-palpebral, en la cavidad oral, en la base del cráneo y a nivel mandibular. En nuestra experiencia, constituye una opción segura para reconstrucciones complejas de cavidades. En el presente artículo los autores exponen el caso de una paciente en quien se reconstruyó un defecto de órbita con un colgajo de fascia temporal superficial prelaminado

The superficial temporal fascia flap is versatile for the reconstruction of tissue defects located in the upper and middle thirds of the face, in the orbital-palpebral region, in the oral cavity, at the base of the skull and at the mandibular level. In our experience, it is a safe option for complex cavity reconstructions. In this article the authors present the case of a patient in whom an orbit defect was reconstructed with a pre-laminated superficial temporal fascia flap

Clinical application effects of portable visual retractor in superficial temporal fascia flap harvesting / 中华烧伤杂志

Objective@#To explore the clinical application effects of portable visual retractor in superficial temporal fascia flap harvesting.@*Methods@#From January 2010 to June 2019, 27 patients meeting the inclusion criteria and planning to perform operation of superficial temporal fascia flap harvesting were admitted to the Department of Plastic and Reconstructive Surgery of the First Clinical Medical Center of the People′s Liberation Army General Hospital. The patients were divided into traditional surgical method group [6 males and 3 females, aged (34±14) years], cold light source retractor group [6 males and 4 females, aged (35±16) years], and portable visual retractor group [7 males and 1 female, aged (30±14) years] according to way of superficial temporal fascia flap harvesting. The superficial temporal fascia flaps of patients in traditional surgical method group were resected by traditional way of resection, and the superficial temporal fascia flaps of patients in cold light source retractor group and portable visual retractor group were resected at assistance of cold light source retractor and portable visual retractor, respectively. Length of incision, operation time, intraoperative blood loss volume, postoperative drainage volume, and postoperative complication of patients in 3 groups were observed and recorded. Data were processed with Fisher′s exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis H test, and Bonferroni correction.@*Results@#The length of incision of patients in visual retractor group was (3.6±0.8) cm, significantly shorter than (12.6±1.6) cm in traditional surgical method group and (5.8±0.9) cm in cold light source retractor group (P<0.05). The incision length of patients in traditional surgical method group was significantly longer than that in cold light source retractor group (P<0.05). The operation time of patients in visual retractor group was 24.0 (23.3, 25.8) min, significantly shorter than 35.0 (30.5, 36.5) min in traditional surgical method group and 28.5 (26.8, 30.5) min in cold light source retractor group (H=16.5, 9.8, P<0.05). The operation time of patients in traditional surgical method group was significantly longer than that in cold light source retractor group (H=6.6, P<0.05). The intraoperative blood loss volume was (26±3) mL of patients in visual retractor group, significantly less than (34±4) mL in traditional surgical method group and (30±6) mL in cold light source retractor group (P<0.05). The intraoperative blood loss volume of patients in traditional surgical method group was significantly more than that in cold light source retractor group (P<0.05). The postoperative drainage volumes of patients in visual retractor group, cold light source retractor group, and traditional surgical method group were (33±4), (34±6), and (31±7) mL, respectively, and there were no significantly statistical differences in postoperative drainage volumes among patients in the three groups (F=0.3, P>0.05). There were no severe complications such as ischemia and necrosis of superficial temporal fascia flaps in patients of the three groups. One patient in cold light source retractor group had subcutaneous hematoma after operation, which was improved by removing stitches and hematoma.@*Conclusions@#Superficial temporal fascia flap harvesting at the assistance of portable visual retractor has the advantages of clear visual field, simple operation, short operation time, small incision, and less intraoperative blood loss.

Key points of high SMAS facelift / 中华整形外科杂志

Objective@#To summarize the key points of high SMAS facelift.@*Methods@#Forty-six patients who had received high SMAS facelift were included in this study. All the patients had subcutaneous dissection by classic facelift incision. The temporal region dissection was performed superficial to middle temporal fascia to avoid temporal branches injury. The zygomatic ligaments were released by sharp and blunt dissection at malar prominence and zygomatic arch. After sub-SMAS dissection, a complete SMAS-platysma flap was raised including temporal, malar, lower face, neck, and one third or half of the midface.@*Results@#Forty patients had postoprative follow-up for more than one year. Twenty patients showed " excellent" results, eighteen patients had " good" results , two patients " common" . The good and excellent rate was 95%.@*Conclusions@#The key points of high SMAS facelift to achieve ideal outcome depend on the safe dissection of superficial temporal fascia and the release of zygomatic ligaments.

Swing-Door Overlay Tympanoplasty: Surgical Technique and Outcomes

OBJECTIVES: The classical overlay tympanoplasty is technically difficult with some disadvantages and thus less popular. However, it is particularly useful for large, anterior perforations. In this study, we describe the technique of a modified overlay graft in the tympanoplasty coined as the swing-door overlay tympanoplasty and report its outcomes. METHODS: Retrospective review of patients undergoing the swing-door overlay tympanoplasty at a tertiary referral center between 2003 and 2016 was performed. Patient who had ossicular abnormality, previous tympanoplasty, and profound hearing loss were excluded. The surgical technique is described in detail. The outcomes were evaluated by the graft success rate, complication rate, and hearing results. The hearing level was determined by four pure-tone average at 0.5, 1, 2, and 4 kHz. Air-bone gap closure was mainly assessed. RESULTS: A total of 306 patients (110 males and 196 females) were included. The mean age was 49.1±16.6 years. Follow-up periods ranged from 6 to 108 months with an average of 18.4 months. The overall graft success rate reached 98.4%. Five graft failures occurred with reperforation in three cases and lateralization in two cases. Postoperative complications occurred in 12 cases (3.9%). Air-bone gap changes (closures) were 7.8±12.8, 5.2±12.2, 5.7±10.2, and 6.0± 12.8 dB at 0.5, 1, 2, and 4 kHz, respectively (all P < 0.001) with an average improvement of 6.2 dB. Postoperative airbone gap was closed to ≤20 dB in 86.9%. CONCLUSION: The swing-door overlay tympanoplasty is a highly successful surgical technique suitable for all types of tympanic membrane perforations. This approach is technically easier than classical overlay tympanoplasty and affords an excellent graft success rate with satisfying hearing results.

Immediate ear reconstruction by superficial temporal fascia flap combined with avulsion auricular tissue / 中华整形外科杂志

Objective@#To explore the application and effect of superficial temporal fascia flap combined with avulsion auricular tissue in emergency auricular restoration.@*Methods@#From June 2015 to December 2015, 6 patients with auricular large area complete avulsion were underwent treatment in Department of Plastic Surgery of General Hospital of Shenyang Military. After thorough debridement, the auricular cartilage scaffold of the avlusion ear and skin was completely stripped. The auricular cartilage was repositioned on its anatomical site and subsequently covered by superficial temporal fascia flap. The free skin was stripped as full-thickness graft to cover the surface of reconstructed ear.@*Results@#All 6 patients with auricle large area complete avulsion achieved immediate repair under emergency condition. The operations were successfully completed and the ears were healed primarily. The patients were followed-up for one year. Five patients with partial auricular avulsion achieved obvious reconstructed auricle profile. The color of reconstructed ear was close to the surrounding skin and the cranioauricular angle was nearly normal. Patients and their families were very satisfied. One patient of total auricular reconstruction had auricular contracture. The auricle profile was not obvious with small size, morphological changes and external auditory canal stenosis.@*Conclusions@#Avulsion auricle and temporal superficial fascia flap can be used to repair partial auricle defects as a first-stage repair with ideal results. It is the best choice for large auricle defects in emergency cases.

Effect of temporal fascia wrapping ethmoid perpendicular plate on repair of nasal septal perforation through endoscopic surgery / 天津医药

Objective To observe therapeutic effect of repairing nasal septum perforation with auto temporal fascia wrapping ethmoid perpendicular plate through endoscopic surgery. Methods Retrospective analysis of 50 cases of nasal septum perforation patient, among whom 30 cases were repaired by traditional surgery and 20 cases were repaired by sand?wich surgery. All patients were examine by CT scan and nasal irrigation therapy were also performed through nasal endosco?py to improves nasal mucosa situation. Endoscopic procedures were performed in the traditional surgical group under local anesthesia, and septum mucosa was separated and shifted to repair septal perforation. On the other hand, temporal fascia of more than 2 times the diameter of the perforation were isolated then, wrapped around the perforation through front line of na?sal incision after separating membrane of the nasal septum cartilage. Now,temporal fascia wrapping autologous ethmoid per?pendicular plates form a rigid verticalsandwich prosthesisand were inserted into perichondrium of septal to repair perfora?tion. Anti-infection and nasal moisturizing treatment were given after operation. Postoperative symptoms and the perfor?mance in follow-ups were recorded. Results Intraoperative blood loss (mL:3.6±1.2 vs 13.4±2.9), operative time (min:25.2± 6.3 vs 46.5 ±10.3), mucosal damage range (mm2:10.2±3.2 vs 20.5±5.3) and mucosal repair time postoperation (d:19.5±3.9 vs 30.2±3.1) were all less in sandwich group than those in traditional group (P<0.05). Successful rate in sandwich group is also higher than that in the traditional surgical group (90.00%vs 46.67%, χ2=9.780, P<0.01) . No recurrence was found during follow-up from 6 months to 1 year in both groups. Conclusion Application of autologous temporalis fascia wrapping per?pendicular plate of ethmoid bone to form a rigidsandwich prosthesisto repair nasal septal perforation by endoscopic sur?gery were effective. It can restore the normal anatomy of the nasal septum.

Various Applications of Deep Temporal Fascia in Rhinoplasty

PURPOSE: In Asians, nasal dorsal and tip augmentation procedures are usually performed at the same time, and most dorsal augmentations use implants. In this study, dorsal augmentation was given by various types of grafts using deep temporal fascia (DTF) for primary rhinoplasty cases using only autologous tissues to improve the curve of hump noses and depressions. For secondary rhinoplasty cases, DTF was used to improve implant demarcation and transparency. Such effectiveness and utility of DTF is discussed. MATERIALS AND METHODS: Between May 2009 and May 2012, we performed rhinoplasty using DTF in 175 patients, which included 78 secondary surgery patients and 128 female patients. The mean age of the patients was 31.4. DTF was utilized with various types of grafts without implants to improve the curve in dorsal augmentation of hump noses and cases that required curve betterment. DTF was used to improve implant demarcation and transparency for secondary cases. RESULTS: The mean follow-up duration was 1.5 years. Of the 175 patients, 81% were satisfied with the natural correction achieved, whereas 19% complained of undercorrection, which was resolved with additional surgery. No specific complications such as nasal inflammation or contractures were observed. CONCLUSION: DTF can be used with various graft methods for correction of radix, dorsal, and tip irregularities. It can also be used to correct implant contour transparency in secondary rhinoplasty and thus may be considered as a useful supplementary graft material in rhinoplasty for Asians.

Progress of superficial temporal fascia application in otoplasty / 国际外科学杂志

Superficial temporal fascia,which has various names,such as temporal fascia,temporoparietal fascia,epicranial aponeurosis and galeal extension,has been used to define the fascial layers of the temporal region.All these different names reflect an anatomical feature of the related fascia.This region exists superficial temporal vessels,the temporal branch of the facial nerve and the auriculotemporal nerve,so is very important in otoplasty.This paper reviews the progress of superficial temporal fascia application in otoplasty.

Rhytidectomy by multi-point suture of musculi dormitator with temporalis fascia graft / 中华医学美学美容杂志

Objective The purpose of this study was to evaluate the efficacy of multipoint transfixion combined with filling of temporal fascia and the lateral orbicularis oculi muscle as an alternative rejuvenation technique on crow's feet wrinkles during face lift.Methods A retrospective review was conducted in 86 patients who underwent crow's feet wrinkles treatment during 2005 and 2009.During operation orbicularis' strength was broken down and blocked when we multi-pointly sutured and fixed the orbicularis oculi and deep tissue,temproal musculofascia was filled on the surface of multi-pointly sutured orbicularis oculi.By postoperative follow-up,complications,aesthetic outcome,and patient's satisfaction were recorded.Results In the group of 86 cases,50 cases were followed up from 3 to 28 months.The effect was lasting obviously and there was no any severe complications,such as hematoma or nerve injury.Patients were satisfied with their results.Among the total,2 patients appeared the temporary movement loss of the eyebrows in one side,but both recovered 3 months later.And 1 case appeared subcutaneous nodular inflammation and recovered after pulling out the suture.Conclusions The authors demonstrate that combination of filling with temporal fascia and the multipoint transfixion of lateral orbicularis oculi muscle is a safe technique,which may be a good alternative for periorbital rejuvenation and help in avoiding lower lid incisions or extensive dissections during face lifting in some cases.

Efficacy of temporalis myofascial flap as an interpositional graft material in the management of tmj ankylosis:.

Temporo-mandibular joint (TMJ) ankylosis is an extremely disabling affliction that causes problems in mastication, digestion, speech, appearance and hygiene. Surgery of TMJ ankylosis needs careful evaluation and planning to yield predictable results. Ankylosis may be corrected surgically by an array of procedures like gap arthroplasty, joint reconstruction and interpositional arthroplasty. Though many types of autogenous grafts and alloplastic materials are available for the interpositioning, the temporalis muscle graft offers significant advantages like ease of harvesting, minimal donor site morbidity and effective coverage of the arthroplasty site. The efficacy of the same is highlighted in this article by its application in four cases of TMJ ankylosis.

Spacer graft using deep temporal fascia in the treatment of paralytic ectropion / 나학회지

BACKGROUND: Spacer graft is known to be a very effective surgical method in the treatment of paralytic ectropion. OBJECTIVE: This study was performed to evaluate deep temporal fascia as a spacer instead of Alloderm in spacer graft to correct paralytic ectropion. METHODS: In seven patients with the lower lid ectropion as a sequela of Hansen's disease, a strip of deep temporal fascia, 4.0cm long and 0.5cm wide, was obtained from the scalp. A separation between the tarsal plate and the capsulopalpebral fascia was made and the strip was inserted into the space. Two ends of the strip were fixed to the medial and lateral canthal ligaments respectively like a sling. RESULT: In all patients, immediate postoperative improvement was achieved, which was to the same degree in the patients treated with Alloderm previously reported. And no serious complications were observed in both donor and graft sites. CONCLUSION: As a spacer in spacer graft, patient's own deep temporal fascia shows good cost-effectiveness ratio and can be an alternative to Alloderm. However, further studies are neccessory to find out the long term efficacy, especially recurrence.

Application of superficial temporal fascia flap in reconstruction of temporal depression / 中华医学美学美容杂志

Objective To evaluate the effect of superficial temporal fascia flap for the reconstruction of temporal depression. Methods According to the degree of temporal depression, we applied folded superficial temporal fascia to reconstruct the temporal depression, combined with forehead and orbital subperiosteal facelift. Results Postoperative follow-up for 1~2 years showed that the method used in subperiosteal facelift combined with temporal depression, maintained a satisfactory long-term full contour. And it improved the facial contour.Conclusions Application of superficial temporal fascia flap in reconstructing the temporal depression combined with facelift for one-stage is a good method. It can get the purposes of tightening the skin and improving the facial contour together. Good results are achieved.

One stage otoplasty with compound framework of Medpor and homogenous rib cartilage / 中华医学美学美容杂志

Objective To find a better method to reconstruct total ear in one stage. Methods In the procedure, a compound framework was formed, in which Medpor acted as ear framework and homogenous rib cartilage as helix-framework after being sculptured, then they were vamped together. The formed framework was covered with adjacent skin flap and homogenous skin graft after it had been covered with superficial temporal fascia flap. Results From January 2001 to Augest 2003, 8 cases of congenital microtia or antotia were treated in this way, and all of them obtained satisfactory appearance in auricle. Conclusion The reconstructed ear has a delicate structure and good appearance, and looks and feels as a real one by this new procedure.

A New Path of Dissection in the Temporal Region to Avoid Injury of the Temporal Fat Pad

The coronal incision is a useful approach to the upper and middle thirds of the facial skeleton, but injury of the frontal branch of the facial nerve can be possible. The authors experienced 56 cases from 31 patients in which trauma to the temporal fat pad and the facial nerve was avoided by dissecting beneath the deep layer of the deep temporal fascia during temporal dissection in subperiosteal face lift, frontofacial monobloc advancement, Le Fort III osteotomy, and open reduction of zygomatic arch fracture. The advantages of this approach include avoiding injury to the facial nerve and minimal bleeding, thereby allowing for an easy and more rapid procedure. Furthermore, there was no development of postoperative temporal depression. This approach is particularly useful for subperiosteal face lifts, procedures requiring exposure of the zygomatic arch, or procedures requiring access to the mid face.