Temporalis Tendon Transfer
Temporalis muscle transfer is a procedure that is used to restore movement, usually to the corner of the mouth. Occasionally the muscle is also transferred to try and improve eye closure, though this latter application is not nearly as popular. The temporalis muscle sits in the temple, and is responsible for biting and chewing. A segment of the muscle is either slid forward from the jaw bone to the corner of the mouth, or flipped over the cheekbone, using the cheekbone as a fulcrum, and secured to the corner of the mouth. Using either technique, when a patient bites down, the corner of the mouth should shift upward imitating a smile. It is a relatively straightforward operation and can be performed through a number of different incisions. It does not ordinarily lead to the same amount of movement as free muscle transfer, but it avoids the need to hook up arteries, veins, and nerves under a microscope, so it takes much less time and expertise. Unfortunately, it can lead to hollowing in the temple area, or a visible bulge over the cheekbone, and generally most people do not feel that it leads to the same aesthetic improvement as other operations. In certain situations, particularly if patients are not appropriate candidates for longer or more complicated operations, it can be an appropriate choice for smile reanimation.