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PubMed1999

Anchoring the detached temporalis muscle in craniofacial surgery.

The temporalis muscle is often detached to enable craniofacial tumour and trauma access surgery. Failure to carefully handle and reattach the muscle often leads to a cosmetic and functional deformity. The authors discuss the principles of elevation of the whole temporal muscle within its surrounding fascia to reduce atrophy. The temporalis muscle is then reattached to its point of origin, using suspensory absorbable sutures attached to 3 mm titanium microscrews placed inferior to the limits of the muscle, to make them non-palpable. The aim is to reduce the postoperative temporal hollowing often seen when these principles are not observed. A series of cases using this technique are reported.

Adolescent↗

PubMed1980

Activity of the temporal and masseter muscles in class II, division 1 malocclusions. An electromyographic investigation.

A quantitative analysis of EMG activity in the masticatory muscles was performed in homogeneous groups of boys with Class II, Division 1 malocclusion and normal occlusion. Integrated EMG recordings from the temporal and masseter muscles were analyzed during maximal biting in the intercuspal position (centric occlusion) and during the chewing of peanuts. The results of the investigation revealed the following: (1) During maximal biting in intercuspal position the boys with Class II malocclusion exhibited less EMG activity in the masseter and temporal muscles than the boys with normal occlusion. In the Class II boys the reduction in EMG activity was most apparent for the masseter muscle. (2) During chewing the Class II subjects showed less EMG activity in the masseter muscle than the normal occlusion subjects. For the temporal muscle, no differences were found between the two occlusion groups. (3) High positive correlations were found between the EMG activity during maximal biting and chewing for both muscles in the two occlusion groups. The impaired muscle activity found in the Class II cases may be attributed to a diverging dentofacial morphology and unstable occlusal contact conditions.

Child↗

PubMed1996

Influence of the thickness of soft tissues overlying human masseter and temporalis muscles on the electromyographic maximal voluntary contraction level.

Skinfold measurements by means of calipers and the use of linear regression functions, representing relationships between maximal EMG activity and skinfold thickness, provide a simple and non-invasive procedure to diminish the influence of the thickness of the subcutaneous tissues overlying jaw-elevator muscles on electromyographic data of the maximal voluntary contraction (MVC) level. This method, which allows an improved comparison between different subject or muscle groups in terms of neuromuscular capacity, has been applied to MVC values from the masseter and the anterior temporal muscles (surface EMG) of 21 healthy males, 14 healthy females, and 14 females suffering from myogenous temporomandibular disorders (TMD). Non-corrected MVC values from both muscle groups were larger for the male controls than for the female controls. As the skinfold thickness was smaller for males than for females, these MVC levels did not differ significantly after correction for skinfold thickness. As the skinfold thickness was very similar for the female TMD patients and the controls, the correction method did not appreciably change the lower MVC values of the TMD patients.

Adult↗

PubMed1993

Deep thermometry of temporomandibular joint and masticatory muscle regions.

A study was designed to measure noninvasively the deep temperature of the temporomandibular joint (TMJ) region and corresponding regions of the masticatory muscles at rest. With a transcutaneous probe, the deep thermometry of the right and left anterior (Ta) and the posterior portion (Tp) of the temporal muscles, the mid-portion of the superficial belly of the masseter muscles (Mm), and the TMJ regions were measured. In 20 normal male subjects, the deep temperature of the Ta region (mean 36.342 degrees C), the Tp region (mean 36.345 degrees C), and the TMJ region (mean 36.06 degrees C) was higher than that of the Mm region (mean 35.897 degrees C) at rest. In addition, no differences in the deep temperature were observed between the right and left Ta, Tp, Mm, and TMJ regions at rest. All of the normal subjects showed differences between the right and left TMJ region of less than 0.3 degrees C. In 10 patients with craniomandibular disorders, however, eight patients showed differences of more than 0.3 degrees C between the asymptomatic and asymptomatic TMJ region. Because of high sensitivity and specificity, the deep thermometry measurements can provide useful non-invasive information.

Adolescent↗

PubMed1997

Changes in neural modulation and motor control during voluntary movement of older individuals.

BACKGROUND: Changes in the modulation of soleus alpha motoneuron excitability, as assessed by H reflexes, and temporal sequencing of the soleus and tibialis anterior muscles during voluntary ankle dorsiflexions and plantar flexions of young (24.7 +/- 11.5; n = 13) and older (68.7 +/- 5.4; n = 13) subjects were assessed to determine potential neural mechanisms that might contribute to motor control changes associated with aging. METHODS: A repetitive stimulation (5 Hz) soleus H-reflex testing protocol and surface electromyography (EMG) were used to assess the latencies of soleus H-reflex changes in relation to tibialis anterior and soleus EMG activations of standing subjects during voluntary ankle dorsiflexions and plantar flexions at self-selected speeds. The pattern and latency of H-reflex changes in relation to EMG activity were compared between young and old subjects. RESULTS: There were no differences in the relative amount of antagonist muscle (soleus) inhibition during voluntary ankle dorsiflexions between young and old subjects (26.4% and 27.2% decrease from resting H-reflex values, respectively). Older subjects, however, required additional time to achieve these levels of inhibition. Delays in the activation of soleus H reflexes during the plantar flexion task were also observed in older subjects. Older subjects also had considerable intra- and intersubject variability in muscle temporal sequencing patterns during ankle plantar flexions. CONCLUSIONS: Although older subjects exhibited similar relative levels of alpha motoneuron inhibition and excitation during voluntary movements, this modulation was delayed when compared to younger subjects. Temporal sequencing of distal muscle activations also appears to undergo change with aging.

Adolescent↗

PubMed1997

Primary maxillary reconstruction after radical maxillectomy using a combined free flap and secondary dynamic suspension.

We report a case of maxillary reconstruction aimed at optimizing facial contour, oral function, and facial animation after radical maxillectomy. In the first stage, using combined latissimus dorsi serratus anterior flaps attached with ribs, we performed a three-dimensional restoration for midface defects. In the second stage, we performed dynamic reconstruction of the nasolabial fold and upper lip using a temporal muscle transposition. As a result, the upper lip was able to be elevated as much as 10 mm when the patient clenched his teeth, and the outcome was judged to be both aesthetically and functionally satisfactory.

Bone Transplantation↗

PubMed2000

Electromyography of the anterior temporalis and masseter muscles of owl monkeys (Aotus trivirgatus) and the function of the postorbital septum.

Anthropoids and tarsiers are distinguished from all other vertebrates by the possession of a postorbital septum, which is formed by the frontal, alisphenoid, and zygomatic bones. Cartmill [(1980) In: Evolutionary Biology of the New World Monkeys and Continental Drift. New York: Plenum, p 243-274] suggested that the postorbital septum evolved in the stem lineage of tarsiers and anthropoids to insulate the eye from movements arising in the temporal fossa. Ross [(1996) Am J Phys Anthropol 91:305-324] suggested that the septum insulates the orbital contents from incursions by the line of action of the anterior temporal muscles caused by the unique combination of high degrees of orbital frontation and convergence. Both of these hypotheses must explain why insulation of the orbital contents could not be achieved by decreasing the size of the anterior temporal musculature with a corresponding increase in size of the remaining jaw adductors, rather than evolving a postorbital septum. One possibility is that the anterior temporalis is an important contributor to vertically directed bite forces during all biting and chewing activities. Another possibility is that reduction in anterior temporal musculature would compromise the ability to produce powerful bite forces, either at the incisors or along the postcanine toothrow. To evaluate these hypotheses, electromyographic (EMG) recordings were made from the masseter muscle and the anterior and posterior portions of the temporalis muscles of two owl monkeys, Aotus trivirgatus. The EMG data indicate that anterior temporalis activity relative to that of the superficial masseter is lower during incision than mastication. In addition, activity of the anterior temporalis is not consistently higher than the posterior temporalis during incision. The data indicate relatively greater activity of anterior temporalis compared to other muscles during isometric biting on the postcanine toothrow. This may be due to decreased activity in superficial masseter and posterior temporalis, rather than elevated anterior temporalis activity. The anterior temporalis is not consistently less variable in activity than the superficial masseter and posterior temporalis. The EMG data gathered here indicate no reason for suggesting that the anterior temporal muscles in anthropoids are utilized especially for incisal preparation of hard fruits. Maintenance of relatively high EMG activity in anterior temporalis across a wide range of biting behaviors is to be expected in a vertically oriented and rostrally positioned muscle such as this because, compared to the posterior temporalis, superficial masseter and medial pterygoid, it can contribute relatively larger vertical components of force to bites along the postcanine toothrow. The in vivo data do not support this hypothesis, possibly because of effects of bite point and bite force orientation.

Animals↗

PubMed1997

Effects of occlusal contact on the level of mandibular elevator muscle activity during maximal clenching in lateral positions.

The aim of this study is to clarify the normal relationship between jaw elevator muscle activity and occlusal contact in lateral positions in order to assess the appropriate anterior guidance of lateral jaw movements for occlusal reconstruction and treatment. The EMG-activity of the right and left masseter, anterior temporal, and posterior temporal muscles of 9 healthy subjects with full, natural dentition was measured with bipolar surface electrodes during two different biting efforts, one involves bite registration by a silicone material containing carbonate powder (BRS) and another is maximal voluntary clenching (MVC), at the right and left canines' edge to edge positions and intercuspal position. The difference in muscle activity between MVC and BRS, which was regarded as the actual muscle activity necessary for MVC, was calculated as a representative value for each muscle activity. When working-side occlusal contact was restricted by the anterior teeth, including the canines, the total actual EMG activity of the 6 jaw muscles had a significantly strong correlation with the frontal angle of the lateral incisal path and the occlusal contact area at the lateral occlusion. This result suggested the possibility that canine guidance would control the muscle activity during lateral tooth clenching.

Adult↗

PubMed1997

Contemporary state of surgical treatment of facial nerve paresis. Preliminary experience with new procedures.

Treatment of paresis of the facial nerve is a serious problem which has advanced greatly during the past three decades. The possibilities of surgical treatment are very extensive--from excisions, implantations of springs and weights, to passive and active supports, muscle transposition, transposition and suture of regional nerves to nervous and muscular transplants. The authors demonstrate their experience with transposition of the temporal muscle and methods of transplants of nervous grafts taken from the sural nerve and in the second stage transplants of a portion of the m. latissimus dorsi or m. serratus ant. in five patients. According to the authors the problem is that patients come for reconstruction operations after long time intervals and sometimes already after several operations. The most suitable surgical procedure must be selected on a strictly individual basis with regard to various mentioned criteria.

Adolescent↗

PubMed2002

Role of magnetic resonance imaging in the assessment of disease activity in thyroid-associated ophthalmopathy.

Two different phases in disease activity are observed during the clinical course of thyroid-associated ophthalmopathy (TAO). The assessment of disease activity is important for predicting the outcome of medical management because medical treatment can be effective in the active stage. The aim of this study was to investigate whether magnetic resonance imaging (MRI) could assess the disease activity in TAO. To investigate the relation between MRI-T2 signal intensity (SI) and extraocular muscle (EOM) size, 11 patients with TAO were evaluated. EOM sizes (enlargement, volume) were measured by MRI-T1 image. T2-SI of EOM was expressed as a percentage of temporal muscle. The reduction in T2-SI was significantly positively correlated with that of EOM enlargement after treatment. Additionally, T2-SI in pretreatment showed a significant correlation with reduction in EOM volume for therapeutic effect, which indicates T2-SI in pretreatment can be one of the reliable parameters for predicting the therapeutic outcome of treatment. To investigate whether MRI-T2 pattern could predict the reversibility of diplopia, 28 patients with Graves' disease with or without ophthalmopathy were evaluated. Patients with TAO with reversible diplopia showed an uniform T2 pattern in enlarged EOM. However, in patients with irreversible diplopia caused by the mechanical limitation of EOM, MRI-T2 image showed no uniformity with a partial appearance of low T2-SI. The partial low T2-SI may indicate the progress of inactive (fibrotic) change in EOM after active (inflammatory) change. In conclusion, MRI is a useful tool for detection not only of EOM enlargement, but also disease activity in TAO. MRI-T2 SI and pattern can predict the outcome of medical management in TAO.

Adult↗

PubMed2004

Relationships among nocturnal jaw muscle activities, decreased esophageal pH, and sleep positions.

The purpose of this study was to examine the relationships among nocturnal jaw muscle activities, decreased esophageal pH, and sleep positions. Twelve adult volunteers, including 4 bruxism patients, participated in this study. Portable pH monitoring, electromyography of the temporal muscle, and audio-video recordings were conducted during the night in the subjects' homes. Rhythmic masticatory muscle activity (RMMA) episodes were observed most frequently, with single short-burst episodes the second most frequent. The frequencies of RMMA, single short-burst, and clenching episodes were significantly higher during decreased esophageal pH episodes than those during other times. Both the electromyography and the decreased esophageal pH episodes were most frequently observed in the supine position. These results suggest that most jaw muscle activities, ie, RMMA, single short-burst, and clenching episodes, occur in relation to gastroesophageal reflux mainly in the supine position.

Adult↗

PubMed1991

Sensory and motor trigeminal evoked potentials to localize the position of trigeminal electrodes.

Analysis of verbal responses to electrical stimulation of the trigeminal ganglion and rootlets has been the only method available so far to localize the electrode tip in the most appropriate trigeminal division or division segment, prior to thermocoagulation during percutaneous treatment for trigeminal neuralgia. A diversity of factors may lead to unreliable verbal responses, resulting in increased morbidity or even therapeutic failure. In an attempt to enhance the accuracy of electrode localization during Sweet's procedure, we describe an electrophysiological method complementary to clinical responses. Sensory trigeminal evoked potentials (STEPs) induced by separate successive orthodromic cutaneous stimulation of the three trigeminal divisions and recorded by the isolated tip of a transoval thermocouple electrode, together with motor trigeminal evoked potentials (MTEPs) elicited by stimulation of the trigeminal ganglion and recorded in the ipsilateral temporal muscle, were sequentially examined in six patients undergoing percutaneous tic treatment during gradual rostro-caudal electrode withdrawal. STEPs and MTEPs showed appropriate correlation with verbal and clinical motor responses at each electrode site. General anaesthesia failed to affect STEPs. Systematic exploration in the awake patient of both verbal and clinical motor responses, together with STEPs and MTEPs, is therefore recommended prior to the induction of radiofrequency lesions in the course of percutaneous treatment for trigeminal neuralgia.

Adult↗

PubMed1996

The influence of attentional factors on short- and long-latency jaw reflexes in man.

Reflexes evoked by applying non-painful taps to an incisor tooth were recorded bilaterally from the jaw-closing masseter and temporal muscles of 21 humans. A series of inhibitory, excitatory, inhibitory and excitatory waves (the Q, R, S and T waves) appeared in full-wave rectified and averaged post-stimulus electromyograms. These reflex responses were affected by the participants' levels of attention. When they undertook mental exercises in the form of arithmetic calculations, increases in electro-myographic activity were found around the transitions between the Q and R and the S and T waves. These increases involved principally a shortening of the inhibitory Q and S waves. There was no significant difference between the occurrence of these effects in the QR and ST segments. However, the effects were seen more commonly when the reflexes were evoked by hard (7.4 mN.s) as opposed to soft (3.4 mN.s) taps. It is concluded that, in man, attentional factors can modulate both short- and long-latency jaw reflexes, particularly when these are evoked by higher-threshold afferent nerves.

Adult↗

PubMed1992

Frequency analysis of electromyographic signals in mandibular elevators at maximum clench level.

Power spectral analysis of electromyogram (ENG) was used to investigate the relationship between mean power frequency (MPF) and sustained contraction time. Surface EMG activity was recorded from masseter and anterior temporal muscles on both sides for seven healthy subjects while clenching at intercuspal position in maximum potential level of these muscles. A visual sense feedback of EMG potential was used to control clenching level. According to linear regression analysis, there was a negative correlation between MPF of EMG and sustained contraction time. The results indicate that the slope of MPF versus contraction time may be used for detecting muscular fatigue in the stomatognathic system.

Adult↗

PubMed1994

Objective evaluation for bite plate therapy in patients with myofascial pain dysfunction syndrome.

An electromyographic study of the masseter and anterior temporal muscles together with questioning patients regarding subjective symptoms was performed on 15 patients with myofascial pain dysfunction (MPD) syndrome prior to and during bite plate therapy. The electromyographic study was evaluated by the slopes of the voltage tension (V/T) curves (calculated as the value of the relative inclination between the integrated electromyram and the biting force). The improvement of subjective symptoms was recognized earlier than the relief of objective symptoms by bite plate therapy. The results confirm that judgement of level of improvement following treatment of MPD syndrome is more appropriate through objective evaluation. Follow-up recording of the voltage tension can be considered to be an objective indicator for patients with MPD syndrome.

Adolescent↗

PubMed1989

[Experimental studies concerning the effect of food consistency on masticatory movement in man].

The purpose of this study is to investigate the relationship of food consistency to patterns of mandibular movement and jaw muscle activity during mastication in adults with normal dentitions. Ten young people who ranged in age from 23 to 26 were studied. Specially made chewing gums of 3 graded consistencies (4.4 x 10(2), 1.4 x 10(4), 1.3 x 10(5) poise), not contain any additive like sugar and flavor, were used as test foods. Mandibular movements were recorded and analyzed using a Mandibular Kinesiograph (Myotronics Research Co.) during chewing of the 3 grades of chewing gums for 40 strokes. Surface EMG signals were also recorded from the bilateral masseteric and anterior temporal muscles. Displacement and velocity of jaw movement, duration of each phase, and amount of EMG activity were then statistically compared among chewing trials of the 3 grades of chewing gums with two way analysis of variance. The results were as followed. With the increase of consistency of chewing gum; 1. Maximal vertical, antero-posterior and lateral displacements were significantly increased (p less than 0.01). 2. Maximal opening and closing velocities were significantly increased (p less than 0.01). 3. Opening phase time was significantly increased while occlusal phase time was significantly decreased (p less than 0.01). Cycle time and closing phase time were about constantly. 4. Burst duration, interval and cycle time were about constantly. 5. Burst activity were significantly increased (p less than 0.01). 6. Burst co-ordination pattern was about constantly.

Adult↗

PubMed1996

Evaluation of masticatory muscles of edentulous patients by computed tomography and electromyography.

On account of its tissue resolution capacity, computed tomography (CT) is an excellent method for the examination and quantitative analysis of the masticatory muscles. The aim of the present study was to evaluate the influence of the long edentulous period by CT on the structure of the main masticatory muscles in 10 edentulous patients and to study their functioning by electromyography (EMG) in connection with the renewal of the dentures. CT scanning was performed before prosthodontic treatment and EMG recordings of the masseter and temporal muscles before treatment and 4 weeks and 6 months after insertion of the new dentures. The results suggest, however, that a long edentulous period is visible not only in the functioning of the masticatory muscles, in terms of decreased EMG activity, but also as decreased density of the muscles which implies muscle atrophy, as seen by CT in the masseter and medial pterygoid muscles.

Adult↗

PubMed1991

Transzygomatic approach to tumours of the parasellar region. Technical note.

A simple transzygomatic approach to the middle fossa centered on the inferior retraction of the temporal muscle hinged on the transected zygomatic arch is described. This approach allows a very low basal exposure of the middle and temporal fossa minimizing the amount of temporal lobe retraction needed to approach intra and extradural lesion in this location. The upper portion of the infratemporal fossa is also reached after removal of the middle fossa skull base. This approach is simple, easily performed, does not require extensive skull base removal, and still offers excellent visualization of the middle fossa and of the upper infratemporal fossa.

Chondrosarcoma↗