Suprazygomatic Aponeurotic McLaughlin Myoplasty for Facial Reanimation

• Published in: Annals of plastic surgery Vol. 85; no. 2; pp. 149 - 157
• Main Authors: Choudhary, Sunil, Khanna, Soumya, Mantri, Raghav, Arora, Prateek
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-08-2020; Copyright Wolters Kluwer Health, Inc. All rights reserved
• Subjects: Adult; Aponeurosis; Bell Palsy; Facial Paralysis - surgery; Humans; Reconstructive Surgical Procedures; Temporal Muscle - surgery
• ISSN: 0148-7043; 1536-3708
• DOI: 10.1097/SAP.0000000000002266

BACKGROUNDSuprazygomatic aponeurotic McLaughlin (SAM) myoplasty technique for facial reanimation is based on the classical McLauglinʼs lengthening temporalis myoplasty with a series of new modifications. A comprehensive review of previously described other orthodromic temporalis myoplasty techniques is also included to give a succinct comparison.
METHODSTwelve adult patients of facial palsy underwent SAM myoplasty for a period of 4 years. Three had congenital facial palsy, 4 patients had facial palsy secondary to acoustic neuromas, 3 were posttraumatic, and 2 patients had Bellʼs palsy.
RESULTSRange of modiolus excursion achieved as measured at 3 months postoperatively on reanimation in our patients was 5 mm to 20 mm with an average of 12.6 mm. With SAM myoplasty technique, we were able to achieve excellent result in 4 patients and good results in 8 patients as evaluated with May and Druker scoring system.
CONCLUSIONSSuprazygomatic aponeurotic McLaughlin myoplasty for facial reanimation demonstrates a successful modification of the classical McLaughlin lengthening temporalis myoplasty, making it more customizable, simple, and predictable by taking the level of transection to the temporalis aponeurosis without the need for zygomatic osteotomy. A new classification of orthodromic temporalis myoplasty based on level of transections is also proposed for the first time. Good to excellent outcomes coupled with high patient satisfaction and low morbidity should make this technique popular among the facial reanimation surgeons.