Use of the temporalis muscle to mitigate the deformities of facial palsy is an accepted technique, but getting the temporalis muscle into the correct position, with the correct tension, is difficult but essential if the operation is to be successful. The authors describe an approach to the temporalis muscle from above the zygomatic arch, combined with an incision in the nasolabial fold, which allows transection of the coronoid process, but preserves the zygomatic arch. The steps of the operation are detailed clearly and cadaveric dissections elucidate the problems further. I think that I would rather observe such an operation in the hands of these experts before trying it out on my own!

Experience and anatomical study of modified lengthening temporalis myoplasty for established facial paralysis.
Hayashi A, Labbe D, Natori Y, et al.
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