[On the arterial supply of the masseter and temporal muscles in the crab-eating monkey (author's transl)].
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Animals↗
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[Myositis ossificans of the pterygoid and temporal muscles with metachronous contralateral involvement].
After reviewing the literature, the authors report a case of myositis ossificans of the right pterygoid and temporalis muscles in a patient undergoing surgery to remove the left medial pterygoid muscle owing to the same pathology. The metachronous localisation in contralateral masticatory muscles compared to the primary site leads the authors to emphasize the post-traumatic and iatrogenic etiology of this rare pathology. In the light of their experience, they underline the importance of a precise diagnosis and surgical exeresis, followed by cautious rehabilitation with the least trauma, if necessary backed by appropriate medical treatment.
Adult↗
A study of the judging the anteroposterior mandibular position by gripping the temporal muscle region.
Greene proposed a method for judging the suitability of the mandibular position from the bulging of the temporal muscle. Using his method, we studied the effect of anteroposterior alteration of mandibular position on the building of this muscle. In the temporal muscle, the area suitable for gripping to check mandibular position was, anteroposteriorly, the point 3/5 of the length between the upper margin of the external auditory meatus and the point of intersection of the Frankfort plane and the line perpendicular to it which was drawn from the outer canthus. Vertically, it was approximately at the point 3/5 of the distance from the bottom of the line from the Frankfort plane to the upper edge of the temporal muscle. In patients whose anteroposterior changes in the tapping point were small, anteroposterior changes of 0.2 mm in mandibular position could be detected. However, in patients who had large anteroposterior changes in the tapping point, anteroposterior changes of 0.5 mm in mandibular position could not be verified.
Dental Occlusion, Centric↗
Electrophysiological study of size and fibre distribution of motor units in the human masseter and temporal muscles.
Probably related to their unique function, human jaw muscles have a specialized muscle-fibre composition different from that of limb and trunk muscles. In jaw muscle from healthy young adults, there were large groups of densely-packed fibres of the same histochemical type, a finding which indicates re-innervation when seen in limb muscles. The number of muscle fibres per motor unit, the local distribution of muscle fibres within motor units and the neuromuscular transmission in human masseter and temporal muscles were examined by single-fibre EMG and macro EMG. One hundred and forty-seven low-threshold motor units in four healthy subjects were recorded. The first dorsal interosseus muscle of the hand was similarly measured. In the jaw and hand muscles the low-threshold motor units were slightly smaller, than in large arm and leg muscles. The temporal muscle differed from the masseter in having significantly-higher fibre density, which may be explained by the higher frequency of small type-II fibres in the temporal causing closer packing of the type-I, low-threshold motor units. The fibre concentration within motor units was similar to that of normal limb muscles without any sign of grouping of fibres from the same motor unit. Normal motor end-plate transmission was another argument against re-innervation.
Adult↗
Histochemical and morphological muscle-fibre characteristics of the human masseter, the medial pterygoid and the temporal muscles.
An extensive histochemical and quantitative analysis of various portions of the human masseter, the medial pterygoid and the temporal muscles was performed in young adult males with normal intermaxillary relationships and complete dentition. There was marked and locally radical intramuscular variability in the muscle-fibre composition. Each muscle and the subunits of the muscles exhibited a characteristic fibre pattern--both the relative frequency and the diameter of the various fibre types differed significantly between the different portions. The fibre pattern was quantitatively different to that of the human lateral pterygoid muscle and both quantitatively and qualitatively dissimilar to that of the human digastric muscle and that of normal limb and trunk muscles. A large proportion of the fibres were ATPase intermediate fibres and must be regarded as being a part of the normal fibre population of the human mandibular elevator muscles. Type IIA fibres were rare. As muscle-fibre differentiation is considered to be influenced by motoneurone function, it can be assumed that the complex fibre pattern of the jaw-closing muscles is related to the unique function of the human mandibular locomotor system. A functional specialization is suggested providing optimal jaw control. Compared with the lateral pterygoid muscle (with predominantly type I fibres) and the digastric muscle (with predominantly type II fibres), the heterogeneous fibre composition of the jaw-closing muscles probably reflects their more complicated activity pattern and functional requirements. The marked difference between the type I and the type II fibre diameters, type II fibres generally being smaller, might reflect evolutionary changes in the masticatory habits, such as adaptation to refined and soft food. The individual variability in fibre composition suggests various levels of utilization and varying ability to adapt to jaw-muscle hyperactivity, to resist fatigue.
Adenosine Triphosphatases↗
Temporal muscle blood flow in chronic tension-type headache.
Temporal muscle blood flow was measured with the xenon 133 clearance technique in 40 patients with chronic tension-type headache and in 13 control subjects. Pressure-pain threshold in the temporal region was determined with an algometer. Patients and control subjects did not differ in any of the blood flow parameters. Resting blood flow at the two sides was highly correlated (Spearman coefficient, r = .61) and no right/left differences could be demonstrated. In both patients and control subjects, blood flow increased approximately fivefold during isometric work (1/3 of a maximum surface electromyogram). Reactive hyperperfusion after isometric work was found in 8 patients and in 1 control subject. There was no definite correlation between the pressure-pain threshold and the corresponding blood flow. It is not likely that temporal muscle ischemia is the cause of muscle tenderness and pain in patients with chronic tension-type headache.
Adult↗
Cortical osteotomy technique for mobilizing the temporal muscle in pterional craniotomies. Technical note.
Although many procedures have already been performed to mobilize and reconstruct the temporal muscle for pterional craniotomies, the authors described a novel cortical osteotomy technique for creating and mobilizing a cortical bone slat along the superior temporal line with the temporal muscle attached to it. Screw fixation of the cortical bone slat then provides secured temporal muscle reconstruction. As such, this new technique minimized damage to the temporal muscle and prevented the formation of an anterior temporal hollow. In addition, key hole and parietal burr hole defects were covered by the cortical bone slat.
Atrophy↗
A comparison of temporal muscle transfer and lid loading in the treatment of paralytic lagophthalmos.
Temporal muscle transfer (n = 78) and lid loading with a gold plate (n = 52) were compared in the treatment of paralytic lagophthalmos. Three sizes of gold plate (1.0, 1.2 and 1.4 g) were used. Lid loading was inferior to temporal muscle transfer in improving functional ability to close the eye, but it did protect the cornea from irritation. There were no significant differences among the sizes of plate, but there was most relief from corneal irritation when the 1.4 g gold plate was used. The plate had to be removed in 25% of the patients, but this did not make the condition worse than before lid loading. Lid loading has the advantage that patients can close their eyes without conscious effort. We therefore recommend lid loading as the first choice for correction of paralytic lagophthalmos, and that temporal muscle transfer should be undertaken after plate removal in only those patients for whom lid loading has not given a satisfactory result.
Adolescent↗
Heteronymous H-reflex in temporal muscle motor units.
An electric stimulation of the masseteric nerve elicits a heteronymous H-reflex in the temporal muscle. The characteristics of this reflex response were investigated by analysis of the firing probability changes of single motor units. Eleven healthy subjects participated in the experiments. The heteronymous H-reflex of the temporal muscle was electrically elicited by stimulation of the masseteric nerve at 120% of the intensity needed for the maximal masseteric M-wave. From 8 to 24 motor units were sampled from the temporal muscle of each subject. Peri-stimulus time histograms of motor unit recordings were built with a 0.5-ms bin width. The mean firing probability was calculated for the 20 ms preceding the stimulus. The firing probability was considered increased when it exceeded the mean by 3 standard deviations. Of 104 sampled motor units, 40 motor units showed a significant increase of the firing probability, which lasted 1 ms or less in 29 of them. In 12 out of 16 motor units, a significant increase of firing probability also persisted at a lower stimulation intensity (120% of the threshold needed to elicit a masseteric M wave). These data indicate that: (1) some temporal muscle motor units are modulated by afferents from the masseter muscle, (2) the heteronymous H-reflex has a monosynaptic component, and (3) there might be a more complex than just monosynaptic organization serving the heteronymous temporal H-reflex. For the latter conclusion regarding synaptic wiring, however, PSTH studies like the present one can offer only indirect evidence, and this question could be better studied in animals.
Adult↗
The use of Gore-Tex Soft Tissue Patch to assist temporal muscle transfer in the treatment of facial nerve palsy.
Temporal muscle transfer remains one of the most widely practiced procedures in dynamic correction of paralysis of facial nerves. In case of shortage of temporal muscle volume, length, and strength, some type of autogenous tissue or implant is required to achieve great stretching and excursion. Several artificial materials have been used in the past, each with its own limitations or problems. We used Gore-Tex Soft Tissue Patch to lengthen and strengthen the muscle-fascia strip. This material is very successful as an implant; it shows excellent tissue tolerance, the porous microstructure encourages tissue attachment and infiltration, and it also resists infection. As a result, reasonable suspension and restoration of orbital and oral sphincters were achieved.
Facial Paralysis↗
Transfer of the temporal muscle for lagophthalmos according to Gillies.
For correction of lagophthalmos different methods have been described such as gold weights, palpebral spring and magnets. Using the transposed temporal muscle is superior to implantation of foreign material. We present a method for correction of lagophthalmos that combines static support with dynamic function. During the last eight years we performed transposition of the temporal muscle in 17 patients. The anterior part of the temporal muscle has been transposed. Corneal irritation and epiphora disappeared in all patients, although a complete correction of lagophthalmos could not be achieved in each case. Chewing was not impaired and closure of the eye could be performed independently from chewing. Because of its low morbidity the transfer of the temporal muscle is the procedure of choice for repair of lagophthalmos.
Eyelid Diseases↗
Transfer of the temporal muscle for lagophthalmos according to Gillies.
For correction of lagophthalmos different methods have been described such as gold weights, palpebral spring and magnets. Using the transposed temporal muscle is superior to implantation of foreign material. We present a method for correction of lagophthalmos that combines static support with dynamic function. During the last eight years we performed transposition of the temporal muscle in 17 patients. The anterior part of the temporal muscle has been transposed. Corneal irritation and epiphora disappeared in all patients, although a complete correction of lagophthalmos could not be achieved in each case. Chewing was not impaired and closure of the eye could be performed independently from chewing. Because of its low morbidity the transfer of the temporal muscle is the procedure of choice for repair of lagophthalmos.
Aged↗
Mandibular reconstruction with full thickness calvarial bone and temporal muscle flap.
Eleven patients underwent mandibular reconstruction with pedicled temporal muscle flaps combined with vascularised or free full thickness calvarial bone grafts. Six were primary and five secondary reconstructions. The indications were squamous cell carcinoma (n = 6), radio-osteonecrosis (n = 4), and gunshot wound (n = 1). Five patients also had endosseus implants, either simultaneously or delayed. The only major complications were necrosis of the whole calvarial bone (n = 1) and permanent facial nerve palsy (n = 1). The advantages of using full thickness calvarial bone are that it is thick enough to take an endosseous implant, morbidity is low, there is virtually no postoperative pain, the scar is invisible, and there is only one donor area for both hard and soft tissue. Transplantation of full thickness calvarial bone and temporal muscle is a viable alternative to an osseomyocutaneous microvascularised free flap for reconstruction of the mandible when the neck has been previously operated on or irradiated, and anastomosis may be critical.
Adult↗
[Closing of central palate defects using a temporal muscle flap].
Large defects of the maxilla are hard to repair. In spite of the prosthesis that covers the defect, patients complain of loss of fluid through the nose when they drink or take liquid food. In five patients the maxillary defect was successfully closed by transposing the anterior part of the temporal muscle or the entire temporal muscle. The donor site was covered by transposing the posterior part of the temporal muscle or by an implant.
Adult↗
Subfascial and submuscular methods of temporal muscle dissection and their relationship to the frontal branch of the facial nerve. Technical note.
The microsurgical anatomy of the temporal and zygomatic branches of the facial nerve are presented along with related local vasculature (frontal and parietal branches of the superficial temporal artery [STA]) as encountered when using subfascial and submuscular temporal muscle dissection techniques for anterolateral craniotomies. Twenty sides were studied in 10 cadaveric specimens that had been previously injected with latex. The rami of the temporal and zygomatic branches of the facial nerve and branches of the STA were dissected out through pterional and orbitozygomatic approaches by using a submuscular or subfascial temporal muscle dissection technique. The three rami of the temporal branch of the facial nerve (the auricularis, frontalis, and orbicularis) were found to run within the galeal plane of the scalp. The zygomatic branch of the facial nerve was found to course deeper than the most caudal extension of the galea, known as the superficial musculoaponeurotic layer. The frontal branch of the STA served as an important landmark for the subfascial or submuscular dissections because excessive reflection of the scalp flap inferior to the level of this vessel would inadvertently injure the frontalis branch of the facial nerve. Subfascial and submuscular dissections of the temporal muscle offer an alternative to the interfascial technique during anterolateral craniotomies. Scalp and temporal dissection performed with careful attention to anatomical landmarks (frontal branch of the STA and the suprafascial fat pad) provides a safe and expeditious alternative to the traditional interfascial technique.
Adipose Tissue↗
Type A botulinum toxin for the treatment of hypertrophy of the masseter and temporal muscles: an alternative treatment.
The treatment of hypertrophy of the masseter and temporal muscles has to date been dominated by conservative and surgical measures. Local therapy with type A botulinum toxin permits an alternative method of treatment. After targeted, sometimes electromyographically controlled, intramuscular injection of the affected muscles, marked inactivity atrophy occurred in the muscles of seven patients over the course of 3 to 8 weeks. This atrophy remained constant over a follow-up period of up to 25 months, and no side effects were observed. Because of its minimal invasiveness, this technique seems to have an advantage over conventional surgical therapy. Consequently, treatment with type A botulinum toxin can be regarded as a sensible alternative to surgery in cases of hypertrophy of the masseter and/or temporal muscles.
Adolescent↗
Algesia and local responses induced by neurokinin A and substance P in human skin and temporal muscle.
Neurokinin A (NKA), substance P (SP) and the two peptides combined (SP + NKA) were injected intracutaneously on the forearm and into the temporal muscle of healthy volunteers. Pain intensity, cutaneous wheal and flare responses and tenderness of the temporal muscle were quantitated. SP but not NKA induced cutaneous pain. This relates the algesic effect of SP to the specific N-terminal amino acid sequence of the peptide, not shared by NKA. NKA, however, potentiated the algesic effect of SP as SP + NKA induced a significantly prolonged cutaneous pain sensation. Both peptides induced wheals, but only SP induced flare. These results confirm previous studies relating wheal formation to the identical C-terminal amino acid sequence of the two peptides and flare reaction to the N-terminal part of SP. Injections into the temporal muscle did not cause pain or tenderness.
Adult↗
Hemangioma of the temporal muscle.
BACKGROUND: Hemangiomas are benign vascular tumors. Because less than 1% of all hemangiomas are intramuscular, only 8 cases of temporal muscle hemangioma have been described to date. This is a case study of a 13-year-old girl who was referred to our institution because of a soft swelling located in the left temple that has enlarged progressively since birth. METHODS: CT scan, angiography and MRI showed a tumor mass lying in the temporal muscle, with homogeneous contrast enhancement. No tumor blush or feeding arteries were detected. At surgical exploration, the tumor appeared to be well demarcated. It was totally excised, sparing the surrounding temporal muscle, which did not present any sign of infiltration. Histopathologic examination showed the lesion to be a cavernous hemangioma. RESULTS: The cosmetic result was excellent, and MRI after 1 month and 2 years showed complete absence of the lesion and no evidence of recurrence. CONCLUSIONS: Although this type of tumor may be treated by various methods surgical excision yields the best results in the short and the long term. The surrounding tissue is spared as much as possible when no signs of infiltration are noted at operation, especially when involving small and functionally important muscles, as in our case.
Adolescent↗