[Lengthening temporalis myoplasty for facial palsy reanimation after parotid surgery].

C Foirest, P Gatignol, I Bernat, G Lamas, F Tankéré
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Abstract

Aim of the study: Share our experience and our results of lengthening temporalis myoplasty (LTM) for facial palsy reanimation after parotid surgery.

Materials and methods: Study of 15 patients after they had had a lengthening temporalis myoplasty, in the same time or after a non conservative parotidectomy of facial nerve. 10 patients suffered from a parotid malignant tumor, one had a jugal epidermoid skin carcinoma invading the parotid, 2 patients had a facial palsy after removal of pleomorphic adenoma recurrence and two patients had a facial nerve schwannoma. 8 patients had a LTM surgery in the same time of the parotid tumoral removal.

Results: No recurrence was observed on the 11 patients who had a carcinoma (average follow up: 27 months). The LTM surgery enabled us to obtain good results at rest for 14 patients (93%) and an intermediate result for one person. The ability to smile was described as good for 10 patients (66.6%), intermediate for 4 of them (26.6%) and unsatisfying for 1 person (6,6%). In the group rehabilitation, the results observed are similar, for the patients who had one or two surgical steps. In 3 cases, we noticed an infectious complication, which led us to operate again. In the 8 cases within lengthening was performed in the same time as parotidectomy, there was no additionnal surgical difficulty.

Conclusion: LTM surgery is an efficient method of rehabilitation. If possible, it should be performed in the same time as tumor removal. As the operational places are different, tumor checking-up and observation are not disturbed by this kind of rehabilitation.

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[延长颞肌成形术治疗腮腺术后面瘫复发]。
目的:分享颞肌延长成形术治疗腮腺术后面瘫复发的经验和效果。材料与方法:对15例行颞肌延长成形术、同时行面神经非保守性腮腺切除术或面神经非保守性腮腺切除术后的患者进行研究。10例发生腮腺恶性肿瘤,1例发生侵犯腮腺的颈表皮样皮肤癌,2例发生多形性腺瘤切除后复发面神经麻痹,2例发生面神经神经鞘瘤。8例患者在腮腺肿瘤切除的同时行LTM手术。结果:11例肿瘤患者均无复发,平均随访27个月。LTM手术使14例患者(93%)在休息时获得了良好的结果,1例患者获得了中等结果。10名患者的微笑能力被描述为良好(66.6%),4名患者的微笑能力被描述为中等(26.6%),1名患者的微笑能力被描述为不满意(6.6%)。在康复组中,观察到的结果是相似的,对于一个或两个手术步骤的患者。其中3例出现感染并发症,导致我们再次手术。8例与腮腺切除术同时行延长手术,均无额外手术困难。结论:LTM手术是一种有效的康复方法。如有可能,应与肿瘤切除同时进行。由于手术部位不同,这种康复方式不影响肿瘤的检查和观察。
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