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A rare case of an intramuscular hemangioma of the temporalis muscle is reported. The clinical examination, carotid arteriogram, computed tomographic scan, and aspiration cytology suggested the vascular nature of the tumor, but an exact diagnosis could only be made after histopathologic examination. Temporary occlusion of the ipsilateral external carotid artery and subperiosteal dissection permitted complete, wide excision without much bleeding.
OBJECTIVE: To study the clinical value of muscle autograft denatured by microwave for repair of gaps in removal of facial neuromas. METHODS: Two cases of patients with facial nerve Schwann cell neuromas were reported. The operations for removal of facial neuromas were completed, and the gaps of the nerves were repaired with muscle autograft denatured by microwave of 250 W for 120 sec. RESULTS: The patients were followed up for two years, and the recovery of facial function on the affected sides were satisfactory. CONCLUSION: Muscle autograft denatured by microwave technique is convenient, highly efficient for repairing facial nerve gap after removal of facial neuroma.
Long-term outcome after surgical treatment of temporomandibular joint ankylosis is not always satisfactory in children. Interposition of a temporalis muscle flap is insufficient to ensure good functional results if the surgical procedure is not followed by careful active and passive physiotherapy. The results can be evaluated only after the child has grown.
A rare case of tumour implantation to the donor site of a temporalis muscle flap is described. This flap was used for intra-oral reconstruction following resection of a squamous cell carcinoma of the retromolar fossa. This surprisingly uncommon complication of ablative cancer surgery should largely be preventable by strict adherence to well established surgical principles.
Thirty-six tension-type headache subjects and 36 non-headache matched controls recorded their temporalis muscle electromyographic (EMG) activity and their pain intensity, stress and physical activity levels in a daily diary. Measurements were performed every 30 min for 6 days (EMG 3 days only). A time-lagged cross-correlational analysis between pain, stress, physical activity, and EMG shows that the highest correlation coefficient values occurred between pain and stress at the same (r = 0.33) and at the two preceding 0.5 h time points (r = 0.21 and r = 0.26) in the headache group. Virtually no correlation was found between pain, stress, or physical activity with EMG for either group. These data show that temporalis muscle activity levels were not related to the rise and fall of the subjects' pain or stress levels. Conversely, elevated stress appeared to be highly related to pain; it occurs as both an antecedent and simultaneous event with elevated headache pain.
The chewing and swallowing activity of jaw-closing muscles was studied longitudinally in 30 partially edentulous subjects who were provided with an immediate complete upper and a partial lower denture. Electromyographic recordings of the anterior temporal and masseter muscles were obtained during habitual chewing of apple and during swallowing of saliva and water, before final extractions and 7 weeks, 6 months, 1 year and 2 years after denture insertion. At the pre-treatment stage, when the patients were chewing with a residual anterior dentition, the mean voltages showed low values compared to findings reported in subjects with a complete natural dentition. After 6 months of denture use, the chewing forces showed significant increases in amplitude, and the increased force of contraction persisted to the 2-year stage. The recordings of swallowing revealed no significant changes in maximal mean voltage during the observation period. However, there was a significant increase in the duration of the swallows after 1 year of denture wearing, which might be related to stabilization of the complete upper denture due to continuing resorption of the maxillary ridge.
Brain stem interneuronal excitability can be assessed by recording the recovery cycle of the blink reflex and exteroceptive suppression of temporalis muscle activity. Abnormal endogenous pain control mechanisms due to disturbed brain stem interneuronal activity have been implicated in the pathogenesis of tension-type headaches. The blink reflex, exteroceptive suppression of temporalis muscle activity, and the recovery curve of both the R2 component of the blink reflex and the ES2 component of the exteroceptive suppression of the temporalis muscle activity were studied in 20 patients with migraine without aura, 32 patients with tension-type headache, and 20 normal controls. In our study, the blink reflex was elicited by stimulation of the supraorbital nerve; the exteroceptive suppression of the temporalis muscle activity was elicited by applying electrical shocks to the labial commissure, both on the lower and upper sides. The recovery cycle was established by delivering paired shocks at different interstimulus intervals. Comparisons were made between normal control subjects, patients with migraine without aura, and patients with tension-type headache. The latency of R1, R2, and R2', the amplitude and size of the R2 and R2' components of the blink reflex, the latency and duration of the ES1 and ES2 components, and the recovery curve of the ES2 component of the temporalis muscle activity did not differ between groups. However, the recovery curve of the R2 component of the blink reflex diminished in patients with tension-type headache compared with the other groups. Our findings indicate reduced excitability of the brain stem interneurons in patients with tension-type headache.
Forensic dentistry plays an essential role in personal identification procedures. An adequate interincisal space of relatively fresh cadavers would be required to obtain detailed dental findings. We developed novel and simple procedures of oral opening which are oriented to the causes of the fixed jaw and conscious of facial damage. Preliminary inspection disclosed three causes of the difficulty of oral opening, namely exceptional drying or parchmenting, rigor mortis and loss of extensibility of the temporalis muscles. Tenotomy on the temporalis muscles for cases with the last two factors, and/or mandibular periosteal stripping for those with the first one were employed to approach the oral cavity of cadavers, and a desired degree of interincisal opening was attained. Single or combinational operation of these methods is definitely effective to obtain odontological data without altering facial configuration.
The paper describes possible future applications of the exteroceptive suppression (ES) of temporalis muscle activity in headache and pain research. ES is examined as a method for investigating the pathophysiology of pain mechanisms, for assisting clinical diagnosis, and for evaluating therapeutic effects. ES is one of the newest methods in headache research which permits an objective analysis of head pain as well as pain mechanisms and accordingly has an important future in headache research.
There are many procedures providing treatment of ptosis. In cases with palpebrae levator palsy, procedures involving mechanical suspension of palpebrae are used. Artificial and natural materials are used to suspend the lid. We describe surgical treatment of blepharoptosis using autogenous temporalis fascia sling. The sling is attached to the tarsus and spreads to the frontalis muscle. We have used this procedure in 12 cases. Full effect of functional elevation of palpebrae was achieved in 14 to 30 days after procedure. We did not encounter any significant complications due to this material. These operative modifications make this procedure more closely parallel to the normal eyelid dynamics and provide consistently good results for this difficult problem.
The effect of transcutaneous nerve stimulation (TNS) was evaluated and compared with placebo TNS in 19 patients (17 women, mean age 33 years) with orofacial functional pain and rheumatic disease involving the temporomandibular joint. In two double-blind noncrossover experiments, high frequency TNS (100 Hz) and low frequency TNS (2 Hz) were evaluated by comparison of the patients' functional and rest pain, muscle and joint tenderness, and jaw function. A significant treatment effect was obtained for all treatment methods regarding functional and rest pain and muscle and joint tenderness. None of the parameters except functional pain, which improved significantly more after high frequency TNS than placebo TNS, revealed any difference between the methods. Jaw function, however, revealed a few differences between high frequency TNS and placebo TNS.
Myostatin (GDF8) and dystrophin are critical molecules for muscle organisation. Myostatin is involved in regulating muscle growth and development, whereas dystrophin is part of the dystrophin-glycoprotein complex (DGC), which anchors the cytoskeleton to the sarcolemma. We examined temporalis muscle morphology and function in myostatin deficient and dystrophin deficient (Mdx) mice in order to determine how myostatin and dystrophin affect bite force and muscle fibre composition. Bite forces from 4-month-old myostatin-/-, dystrophin deficient (Mdx) and normal control mice were measured by load cell and field stimulation of the temporalis muscle. Tissue sections were stained with haemotoxylin and eosin (H&E) and the periodic acid-Schiff reaction (PAS) to assess morphology and fibre type differences. A positive relationship between bite force and muscle mass for both genetic models was observed. Both Mstn-/- and Mdx mice showed significant elevation in bite force and muscle mass. Histological examination revealed greater muscle fibre cross-sectional area variability in Mdx mice (ANOVA, F=5.6, P<0.01). Surprisingly, the Mstn-/- mice demonstrated a disproportionate increase in bite force at higher stimulation frequencies with comparison of regression lines for force-frequency data (ANOVA, F=3.46, P<0.07). Muscle fibre typing using a PAS staining technique revealed significantly more type IIx/b glycolytic muscle fibres in the Mstn-/- mice. Our results suggest that histopathologies associated with Mdx mice did not diminish gross temporalis structure or function, whilst the force-frequency changes associated with Mstn-/- mice were reflected in an elevation of type IIx/b fibres.
We devised a technique to fix the temporalis muscle to the transplanted hydroxyapatite implant by using a titanium plate, which is fixed to the hydroxyapatite ceramic implant by screws and achieves good clinical results. The size, shape, and curvature of the hydroxyapatite ceramic implants were determined according to full-scale models fabricated using the laser lithographic modeling method from computed tomography data. A titanium plate was then fixed with screws on the implant before implantation, and then the temporalis muscle was refixed to the holes at both ends of the plate. The application of this technique reduced the hospitalization time and achieved good results esthetically.
Differential Lissajous electromyography (DL-EMG), a method of representing the simultaneous EMG values of two paired muscles as a single, continuous figure, was used in chewing tests with a sample of Japanese women having normal occlusion compared with a like group of Japanese female adolescents, having Class II, Division 1 malocclusion. For the normal sample, the DL-EMG figures described by the coordinated activity of the bilateral temporal and masseter muscles during chewing gum mastication typically appeared as repetitions of loops. Statistical data were gathered on the total EMG voltages, and on the location, rotational direction, and orientations of the DL-EMG loops when graphed onto Cartesian coordinates. These data were compared with those taken from the Class II sample. Significant differences were observed in the latter group for the EMG voltage levels of the balancing-side masseter muscles. The DL-EMG figures of the Class II group also showed irregularities in the shapes, locations, rotational directions, and orientations of the loops, indicative of irregular masticatory patterns. These data suggest that with sufficient control of factors such as age and sex, electromyography and especially DL-EMG techniques can be useful for characterizing masticatory differences between various occlusal groups.
The levels of amyloid-beta40 (Abeta40) and Abeta42 peptides were quantified in temporalis muscles and brain of neuropathologically diagnosed Alzheimer disease (AD) and of nondemented individuals. This was achieved by using a novel analytical approach consisting of a combination of fast-performance liquid chromatographic (FPLC) size exclusion chromatography developed under denaturing conditions and europium immunoassay on the 4.0- to 4.5-kd fractions. In the temporalis muscles of the AD and nondemented control groups, the average values for Abeta42 were 15.7 ng/g and 10.2 ng/g (P = 0.010), and for Abeta40 they were 37.8 ng/g and 29.8 ng/g (P = 0.067), respectively. Multiple regression analyses of the AD and control combined populations indicated that 1) muscle Abeta40 and muscle Abeta42 levels were correlated with each other (P < 0.001), 2) muscle Abeta40 levels were positively correlated with age (P = 0. 036), and 3) muscle Abeta42 levels were positively correlated with Braak stage (P = 0.042). Other forms of the Abeta peptide were discovered by mass spectrometry, revealing the presence of Abeta starting at residues 1, 6, 7, 9, 10, and 11 and ending at residues 40, 42, 44, 45, and 46. It is possible that in AD the skeletal muscle may contribute to the elevated plasma pool of Abeta and thus indirectly to the amyloid deposits of the brain parenchyma and cerebral blood vessels. The increased levels of Abeta in the temporalis muscles of AD patients suggest that alterations in AbetaPP and Abeta metabolism may be manifested in peripheral tissues.
The effect of a long mental stress on the hemodynamics of masticatory muscles has not been investigated to date. We hypothesized some hemodynamic and electromyographic changes in jaw-closure muscles related to sympathetic nervous system activity. While healthy adult female volunteers performed a two-hour mental stress task, electromyographic activity of the temporal and masseteric muscles was recorded, and hemodynamic changes of the masseter muscle were measured non-invasively. Autonomic function was assessed by heart rate spectral analysis. Integrated electromyographic activity of the temporalis muscle, but not the masseter muscle, showed an increase that coincided with the increase in sympathetic nervous activity. In the masseter muscle, despite little change in integrated electromyographic activity, notable changes were found in hemodynamic parameters. These results suggest that hemodynamics of jaw muscles is susceptible to mental stress, implying a potential role in the etiology of jaw muscle dysfunction associated with mental stress.
High-resolution optoelectronic mandibular tracking and fine-wire electromyographic (EMG) data from the anterior temporalis muscles of laboratory rats (Rattus norvegicus) were collected during mastication (chewing) and bruxing/thegosis (grinding sharpening of teeth) in order to test for task-related activity patterns of the anterior temporalis. Analyses of the collected data revealed that masticatory and bruxing/thegosis cycles displayed significantly different patterns of movement trajectories, displacement, duration, velocity, and acceleration in all three spatial dimensions (frontal vertical, frontal horizontal and sagittal horizontal). Activity patterns in the anterior temporalis during masticatory and bruxing/thegosis behaviours were also significantly different from each other. High-resolution analyses revealed that the masticatory cycle had both opening-burst and closing-burst phasic patterns of anterior temporalis activity while the bruxing/thegosis cycle displayed only opening-burst phasic patterns. The opening- and closing-burst attributes of anterior temporalis phasic activity patterns in relation to physiological centric occlusion also revealed significant differences between masticatory and bruxing/thegosis behaviours. These data demonstrate that the anterior temporalis muscle of the laboratory rat does indeed display task-related activity patterns depending upon the manifested oral behaviour. The task-related shifts of EMG patterns in the anterior temporalis between masticatory bruxing/thegosis behaviours in the same animal suggests a complex neurophysiological substrate that coordinates the three-dimensional expression of phasic activity patterns in the muscle. The radically different nature of masticatory and bruxing/thegosis cycles and their associated EMG patterns in the anterior temporalis suggest the possible existence of a bruxing/thegosis pattern generator in addition to the masticatory one. Careful, high-resolution analyses of these rat behaviours by combined optoelectronic/EMG techniques suggest that the rat model for human bruxism may prove useful in future studies.
A study was performed to evaluate relationships between mandible position, dynamics, muscle activity and head posture while swallowing by use of surface EMG and mandible kinesiograph on two population groups (118 pathologics and 31 controls). The study produced the following: 1. specific mandible dynamics with a very fast rising phase (0.3 sec) and longer phase of stabilization (1.5 sec); 2. more than 60% of the subjects presented deglutition at occlusion level, the others swallowing at a distance of 0.1-4.6 mm; 3. the whole muscle activity (temporals, masseters, digastrics, sternocleidomastoids) lasted 1.5 sec with no correlation of duration to age; 4. sternocleidomastoids fired at swallowing with an effort of one-half of temporals or masseters; 6. firing order presented a particular pattern: digastrics more often first, sternocleidomastoids more often last. No differences were found between the pathologics and controls. Findings suggest that the oral phase or mandible dynamic, and the stabilization phase or oropharyngeal phase of swallowing, has an individual role that is important in head postural equilibrium.