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PubMed2000

The role of craniotomy and trephination in the treatment of chronic subdural hematoma.

The treatment of chronic subdural hematoma by craniotomy was the procedure of choice in the early part of this century. It has since been replaced by less invasive techniques but retains a limited role in the management of this condition. A new procedure involving a small craniectomy and marsupialization of the hematoma cavity to the temporalis muscle is described. The results of this treatment compare favorably with the more commonly performed drainage methods.

Craniotomy↗
PubMed2001

[Anatomical study of the temporalis tendon. Value in temporalis lengthening myoplasty].

The lengthening temporalis myoplasty is indicated in long standing and congenital facial paralysis. Its principle is the transfer of the coronoid tendinous insertions onto the lip and the nasolabial fold. The knowledge of the anatomy of this strong and wide tendon is necessary to use successfully their anatomical advantages. A study of ten cadavers (20 temporalis muscles) confirmed the surgical anatomy found during lengthening temporalis myoplasty procedure: the strong tendon, when liberated from the coronoid process, is from 4 to 6 cm long.

Cadaver↗
PubMed1980

Avascular necrosis of the mandibular ramus in the baboon (Papio ursinus) following orthognathic surgery.

The maintenance of an adequate blood supply to the mandible following orthognathic surgery is of extreme importance if satisfactory healing is to be achieved. With this object in mind, this study was undertaken to assess the effects of disrupting the blood supply of the baboon mandible by means of L- and C-osteotomies. Ten adolescent baboons of the species Papio ursinus were used as the experimental animals for the study. On five of them a modified vertical subsigmoid osteotomy (L-osteotomy) and on five a C-osteotomy of the mandibular ramus were performed. In each experimental animal the osteotomy was undertaken on one side of the mandible only, the other side serving as a control. After a postoperative period of 14 days the animals were killed, the entire mandible removed, and the tissues prepared for examination with the light microscope. Histometric analysis revealed a significant degree of avascular necrosis in certain areas of the proximal or condylar fragments and to a lesser extent in the distal fragment. Avascular necrosis was also seen on the control side. It was also revealed that the periosteum and attached muscles of mastication play a role in the blood supply of the mandible and that the additional attachment of the temporalis muscle to the proximal fragment is of no advantage in enhancing the vascularity of that fragment.

Animals↗
PubMed2005

Mechanism of hypertensive nephropathy in the Dahl/Rapp rat: a primary disorder of vascular smooth muscle.

The Dahl/Rapp salt-sensitive (S) rat is a model of salt-sensitive hypertension and hypertensive renal disease. This study explored the role of vascular remodeling in the development of renal failure in S rats. Groups of S and Sprague-Dawley rats were given 0.3 and 8.0% NaCl diets for up to 21 days and evidence of smooth muscle proliferation identified using immunohistochemistry that showed nuclear accumulation of proliferating cell nuclear antigen and 5-bromo-2'-deoxy-uridine. Compared with the other three groups, S rats on 8.0% NaCl diet showed increased nuclear labeling of cells of the aorta and arteries and arterioles of the kidney by the end of the first week of study. Progressive luminal narrowing of the interlobular arteries and preglomerular arterioles occurred in S rats over the 3 wk on the 8.0% NaCl diet. Accumulation of pimonidazole adducts and nuclear accumulation of hypoxia-inducible factor-1alpha (HIF-1alpha) were used as markers of tissue hypoxia. By the end of the second week of study, pimonidazole levels increased in S rats on 8.0% NaCl diet and deposition was apparent in tubular cells in the cortex and medulla. At the completion of the experiment, HIF-1alpha levels were increased in nuclear extracts from the cortex and medulla of S rats on this diet, compared with the other three groups of rats. The data demonstrated a disorder of the vascular remodeling process with proliferation of vascular smooth muscle cells temporally followed by development of tissue hypoxia in the hypertensive nephropathy of S rats on 8.0% NaCl diet.

Animals↗
PubMed1976

Assembly of the sarcoplasmic reticulum. Biosynthesis of calsequestrin in rat skeletal muscle cell cultures.

Temporal patterns of biosynthesis of the sarcoplasmic reticulum protein, calsequestrin, were analyzed and compared with rates of ATPase synthesis in primary cultures of rat skeletal muscle cells. Rates of synthesis were measured by the incorporation of radioactive leucine into the isolated proteins. Cells at various stages of differentiation were incubated for 2 h with tritium-labeled leucine and extracted with detergent. The extracts were incubated with antibodies specific against calsequestrin or the ATPase and immunoprecipitates were separated by disc gel electrophoresis. Incorporation of radioactivity into bands identified as calsequestrin or the ATPase was analyzed by counting of gel slices. In Dulbecco's modified Eagles medium (DME medium) containing 0.1 volume of horse serum and 0.005 volume of chick embryo extract, the cells began to fuse after about 50 h in culture, forming multinucleated myotubes. Calsequestrin synthesis was barely detectable after 24 h in culture. After 44 h, before fusion of myoblasts began, the rate of calsequestrin synthesis increased severalfold. The rate of synthesis continued to increase until about 72 h and then diminished. If cells were transferred at 44 h to DME medium containing 0.2 volume of fetal calf serum and 0.08 volume of chick embryo extract, fusion was delayed by about 20 h. In this medium the rate of calsequestrin synthesis diminished after a peak at 44 h but, by contrast, the rate of synthesis of the ATPase increased dramatically following fusion at about 80 h. If cells were transferred at about 40 h to DME medium containing 0.1 volume of horse serum and only 60 muM Ca2+ the cells did not fuse and, again, the rate of calsequestrin synthesis was diminished after a peak at about 40 h. By contrast the rate of ATPase synthesis increased sharply in spite of the lack of fusion. Both proteins were degraded with a half-life of about 20 h. These studies show that the synthesis of calsequestrin, an extrinsic membrane protein, and the ATPase, an intrinsic protein of the same membrane, are synthesized under separate control.

Adenosine Triphosphatases↗
PubMed2005

Calcium-activated potassium channel of the tobacco hornworm, Manduca sexta: molecular characterization and expression analysis.

Large-conductance calcium- and voltage-gated potassium channels (BK or Slowpoke) serve as dynamic integrators linking electrical signaling and intracellular activity. These channels can mediate many different Ca2+-dependent physiological processes including the regulation of neuronal and neuroendocrine cell excitability and muscle contraction. To gain insights into the function of BK channels in vivo, we isolated a full-length cDNA encoding the alpha subunit of a Slowpoke channel from the tobacco hornworm, Manduca sexta (msslo). Amino acid sequence comparison of the deduced Manduca protein revealed at least 80% identity to the insect Slo channels. The five C-terminal alternative splice regions are conserved, but the cloned cDNA fragments contained some unique combinations of exons E, G and I. Our spatial profile revealed that transcript levels were highest in skeletal muscle when compared with the central nervous system (CNS) and visceral muscle. The temporal profile suggested that msslo expression is regulated developmentally in a tissue- and regional-specific pattern. The levels of msslo transcripts remain relatively constant throughout metamorphosis in the CNS, transiently decline in the heart and are barely detectable in the gut except in adults. A dramatic upregulation of msslo transcript levels occurs in thoracic but not abdominal dorsal longitudinal body wall muscles (DLM), suggesting that the msSlo current plays an important role in the excitation or contractile properties of the phasic flight muscle. Our developmental profile of msslo expression suggests that msSlo currents may contribute to the changes in neural circuits and muscle properties that produce stage-specific functions and behaviors.

Age Factors↗
PubMed1983

Reflex sensitivity of human jaw-closing muscles during the silent period following a jaw jerk.

Two successive force impulses were exerted upon the mandible in the opening direction with intervals of 20 to 120 ms. Electromyographic responses were recorded from the right temporal and masseter muscles and from the anterior belly of the right digastric muscle. Mandibular movement was recorded in the sagittal plane. The first-force impulse evoked a jaw jerk followed by a silent period. The jaw jerk following the second-force impulse was depressed when the interval between the force impulses was shorter than a certain value. The depression was total for at least 20 ms after the first jaw jerk. It is suggested that the silent period is the result of more than one inhibitory mechanism. From comparison of the resulting mandibular movement with movements resulting from single-force impulses, it is concluded that the jaw jerk may contribute to a small but significant extent to the stiffness of jaw-closing muscles.

Adult↗
PubMed2000

Temporalis muscle transfer for facial paralysis: a further refinement.

Facial nerve paralysis can occur due to failure of the central driving mechanism (nuclear or supranuclear pathology), failure of the conduit between the brainstem and the peripheral musculature (the facial nerve), or failure of the peripheral end organ (the neuromuscular system). Where the peripheral neuromuscular system fails, the options for dynamic reanimation include a regional muscle transfer driven by another ipsilateral cranial nerve, or a free muscle transfer driven by the contralateral facial nerve. Temporalis muscle transfer is an example of regional muscle transfer and has been used since early in the twentieth century. A further refinement, involving mobilization of the coronoid process of the mandible in continuity with the insertion of the temporalis muscle via a nasolabial fold approach, using fascial strips to re-create movement around the mouth, is presented.

Adult↗
PubMed2005

Cochlear temperature correlates with both temporalis muscle and rectal temperatures. Application for testing the otoprotective effect of hypothermia.

CONCLUSIONS: During systemic hypothermia, the internal temperature of the rat cochlea correlates best with the temporalis muscle and rectal temperatures. These positive correlations will be used in future studies to assess the efficacy of mild and moderate hypothermia to protect hearing against the progressive loss caused by electrode insertion in a clinically relevant model of cochlear implantation trauma. OBJECTIVE: To monitor the internal temperature of the cochlea during induced systemic hypothermia using a reference tissue instead of an internal cochlear temperature probe. MATERIAL AND METHODS: The temperatures of the cochlea, brain, temporalis muscle and rectum were determined during periods of normothermia (37 degrees C), mild (33 degrees C) and moderate (30 degrees C) hypothermia and slow rewarming in anesthetized adult Fisher rats. These values were compared using statistical analysis to establish the best correlations between the temperature of the cochlea and the temperature at the three other temperature measurement sites. RESULTS: The strongest correlations with the internal temperature of the cochlea during the induction of mild-to-moderate hypothermia were obtained for the temperatures of the ipsilateral temporalis muscle and rectum.

Animals↗
PubMed1997

The temporalis muscle flap in intraoral reconstruction.

BACKGROUND: Reconstruction following excision of intraoral tumours presents a challenge to the head and neck surgeon. The purpose of hte present study was to review the authors' initial experience with the temporalis muscle flap. METHODS: A retrospective review fo the use of 21 temporalis muscle flaps in intraoral reconstruction at Christchurch Hospital was performed. The muscle was used to reconstruct defects of the oral tongue, tongue base, buccal mucosa, maxilla, soft palate, retromolar trigone and tonsillar region. Epithelial cover was provided by either split-skin grafting or ingrowth from adjacent mucosa. RESULTS: One flap necrosed and one patient developed a wound haematoma requiring drainage. One patient developed a transient frontal weakness. The long-term functional results were excellent, except for one patient with slight tongue tethering. In one patient bilateral flaps were used to reconstruct a bilateral maxillectomy defect. CONCLUSION: The temporalis muscle flap is a useful option for reconstruction of moderate defects in the posterior oral cavity and oropharynx.

Female↗
PubMed2004

Anatomic study of the tendinous insertion lamina of the temporalis muscle.

Lengthening temporalis myoplasty is indicated in long-standing and congenital facial paralysis. Its principle is the transfer of the coronoid tendinous insertions onto the lip and the nasolabial fold. Knowledge of the anatomy of this strong and wide tendon is necessary for successful use of its anatomic advantages. A study on 10 cadavers (20 temporalis muscles) confirmed the surgical anatomy found during lengthening temporalis myoplasty procedures: the strong tendon, when freed from the coronoid process, is 4-6 cm wide.

Aged↗
PubMed1996

Three-dimensional structure of the human temporalis muscle.

BACKGROUND: The maximal force a muscle is capable of producing is proportional to its physiological cross-sectional area and its excursion range to the length of the muscle fibers. The length of the sarcomeres is a major determinant for both force and excursion range. The human temporalis muscle is an architecturally complex muscle, and little is known regarding the possible heterogeneous distribution of these parameters throughout the muscle. The objective of this study was to determine this distribution for different muscle portions and to examine the functional consequences. METHODS: In eight cadavers, sarcomere lengths, fiber lengths, and physiological cross-sectional areas were measured for the closed mouth position in six different anteroposterior portions of the temporalis muscle. To determine the spatial position of the muscle portions, the three-dimensional coordinates of attachment sites of a number of fiber bundles were registered. These parameters were used as input for a mathematical model with which sarcomere length changes and the consequences for the production of active force at different open positions of the jaw were estimated. RESULTS: At the closed-jaw position, average sarcomere length ranged between 2.26 and 2.34 microns and did not differ significantly among the muscle portions. Average fiber bundle length ranged between 21.7 and 28.9 mm and differed significantly among the muscle portions. The physiological cross-sectional area ranged between 1.82 and 2.93 cm2; the smallest values were found posteriorly, and the largest values anteriorly. The line of pull of the anteriormost muscle portion was slightly inclined anteriorly and medially, whereas the posteriormost portion was relatively strongly inclined backwardly and laterally. The model predicted that during jaw open-close movements a nonuniform change in length of the sarcomeres would occur; sarcomere excursions were smaller posteriorly than anteriorly. Different muscle portions seemed to function along different parts of the active length-force relationship. CONCLUSIONS: The temporalis muscle is an architecturally heterogeneous muscle. Different muscle portions are capable of producing different maximum force and excursion range, and the portions have the capability of performing different mechanical actions.

Aged↗
PubMed2004

Clinicopathologic conference: trismus following dental treatment.

Myositis ossificans traumatica is a rare clinical entity in the maxillofacial region. We present a case of myositis ossificans traumatica of the temporalis muscle following dental treatment in the form of a clinicopathologic conference. A review of the literature supporting our findings is provided.

Aged↗
PubMed1979

Axial muscle and myocutaneous flaps: a recent concept in wound closure.

Until the last decade, the greatest advances in reconstructive surgery have been skin grafting and the advent of pedicle flaps. More recently a new understanding of the discrete vascular anatomy of the skin and other composite tissues has enabled the transfer of these tissues with far more reliability, either locally or--using microvascular techniques--to a distance. The axial and random concept of blood supply of flaps will be outlined. A brief historical background of the development of axial flaps is included. A synopsis of the anatomy, uses and limitations of the commonly used and proven muscle and myocutaneous flaps in our experience is reported. In the final discussion, a new and simple classification of wound closure is proposed which encompasses all the recent developments in this field.

Axilla↗
PubMed2001

One-stage reconstruction of the eye socket with vascularized temporalis muscle flap in orbital exenteration.

AIM: Two cases of one-stage reconstruction of exenterated orbit with vascularized temporalis muscle flap in oncological patients are presented. The anatomical characteristics of the temporalis muscle flap and the choice of one-stage or delayed reconstruction of the exenterated orbit are discussed. METHODS: Two patients were operated for malignancy recurrence during the period May-November 2000. One patient suffered recurrent squamous cell carcinoma in the left nasolabial region that infiltrated the lower eyelid and periorbit. The other patient had recurrence of previously operated primary rhabdomyosarcoma of the orbit. Both patients underwent orbital exenteration. In the first patient it supplemented the tumor excision and partial maxillary excision resulting in large orbitomaxillary defect communicating with the nasal meatuses. RESULTS: In both patients good filling effect and isolation of the orbit from the neighbouring nasal meatuses and cranial cavity were obtained using vascularized temporalis muscle flap. CONCLUSION: The vascularized muscle flap appears a reliable technique and method of choice in one-stage as well as in delayed reconstruction in orbital exenteration.

Female↗
PubMed1990

Cardiac dysrhythmias complicating maxillofacial surgery.

Cardiac asystole, bradycardia and other dysrhythmias are complications associated with surgery of the craniofacial and maxillofacial structures. These dysrhythmias have been discussed frequently in ophthalmology but less attention has been paid to this problem in the maxillofacial surgery literature. Eight patients, 6 men and 2 women, who underwent maxillofacial surgery during a 16-month period at the Victoria General Hospital, Halifax, Canada demonstrated either asystole or bradycardia. This group of patients represents 1.6% of the total number of patients treated during the 16-month period. Six patients demonstrated either asystole or bradycardia during stretching of the soft tissues associated with advancement of the maxilla after bony mobilization. Two patients had either asystole or bradycardia during manipulation of the temporalis muscle fibres during surgery to correct total bony ankylosis of the temporomandibular joint. The etiology of this relatively rare but troublesome complication is discussed.

Adolescent↗