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Kitamura K, Ishizuka S, Kim JH, Yamamoto H, Murakami G, Rodríguez-Vázquez JF, Abe SI. Development and growth of the temporal fascia: a histological study using human fetuses. Anat Cell Biol 2024:acb.23.298. [PMID: 38590096 DOI: 10.5115/acb.23.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/03/2024] [Accepted: 02/17/2024] [Indexed: 04/10/2024] Open
Abstract
The temporal fascia is a double lamina sandwiching a thick fat layer above the zygomatic bony arch. To characterize each lamina, their developmental processes were examined in fetuses. We observed histological sections from 22 half-heads of 10 mid-term fetuses at 14-18 weeks (crown-rump length, 95-150 mm) and 12 near-term fetuses at 26-40 weeks (crown-rump length, 215-334 mm). The superficial lamina of the temporal fascia was not evident at mid-term. Instead, a loose subcutaneous tissue was attached to the thin, deep lamina of the temporal fascia covering the temporalis muscle. At near-term, the deep lamina became thick, while the superficial lamina appeared and exhibited several variations: i) a mono-layered thick membrane (5 specimens); ii) a multi-layered membranous structure (6) and; iii) a cluster of independent thick fasciae each of which were separated by fatty tissues (1). In the second and third patterns, fatty tissue between the two laminae was likely to contain longitudinal fibrous bands in parallel with the deep lamina. Varying proportions of the multi-layered superficial lamina were not attached to the zygomatic arch, but extended below the bony arch. Whether or not lobulation or septation of fatty tissues was evident was not dependent on age. The deep lamina seemed to develop from the temporalis muscle depending on the muscle contraction. In contrast, the superficial lamina developed from subcutaneous collagenous bundles continuous to the cheek. Therein, a difference in development was clearly seen between two categories of the fasciae.
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Affiliation(s)
- Kei Kitamura
- Department of Histology and Developmental Biology, Tokyo Dental College, Tokyo, Japan
| | | | - Ji Hyun Kim
- Department of Anatomy, Jeonbuk National University Medical School, Jeonju, Korea
| | - Hitoshi Yamamoto
- Department of Histology and Developmental Biology, Tokyo Dental College, Tokyo, Japan
| | - Gen Murakami
- Division of Internal Medicine, Cupid Clinic, Iwamizawa, Japan
| | | | - Shin-Ichi Abe
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
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Sakamoto Y. The branching pattern of the middle temporal artery and the relation with the temporal fascia. Surg Radiol Anat 2021. [PMID: 34181041 DOI: 10.1007/s00276-021-02790-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Although the middle temporal artery is used for maxillofacial and otological flap surgeries, the anatomical knowledge of the artery is insufficient to corroborate its usage. This study has investigated the interrelationship between the artery and the temporal fascia to enhance its availability. METHODS The middle temporal artery was dissected in ten cadavers, and its spatial relations with the temporal fascia and muscle and the adjacent structures were examined. RESULTS The middle temporal artery arose behind the mandibular head or neck and in front of the external acoustic meatus. It penetrated the temporal fascia external to the junction between the zygomatic process and the supramastoid crest. The artery gave off a thin branch in the space between the superficial and the deep layers of the fascia and is divided into two branches piercing the deep layer to supply the temporalis. The anterior branch anastomosed with the deep temporal artery; furthermore, it gave off the slender ramus coursing on the base of the zygomatic process to communicate with the masseteric artery. The posterior branch passed along the supramastoid crest, gave off a slender ramus and ascended in the groove of the temporal bone. CONCLUSION The branching pattern of the middle temporal artery and its positions relative to the temporal fascia and the landmark structures are helpful in identifying the artery, designing favourable flaps and avoiding unfavourable bleeding during surgery. They are also beneficial in developing the clinical usage of the artery.
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Sihag RK, Gupta SK, Sahni D, Aggarwal A. Frontotemporal Branch of the Facial Nerve and Fascial Layers in the Temporal Region: A Cadaveric Study to Define a Safe Dissection Plane. Neurol India 2021; 68:1313-1320. [PMID: 33342860 DOI: 10.4103/0028-3886.304113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Anatomy of the temporal region is complex with controversy over the relationship of fascial planes with the upper division of the facial nerve. Objective This study aimed to identify the safe surgical landmarks to preserve the frontotemporal branch of the facial nerve during surgery and define the safest approach for surgical procedures in this region. Material and Methods The anatomical relationship of the frontal branch of the facial nerve, superficial temporal artery (STA), fascial planes, and fat pads was determined after dissection on 10 cadaveric heads, that is (20 sides) Dissection was performed layer by layer from skin to bone. Results The temporoparietal fascia was made up of multiple (3-4) layers above the zygomatic arch and these layers were integrated with thin fibrous septa. The frontotemporal branch of the facial nerve (FTFN) was observed in a deeper part of temporoparietal fascia and superficial fat pad. The frontotemporal branch of the facial nerve (FTFN) crossed the zygomatic arch as two branches in 25%, as three branches in 65% and as four branches in 10% of specimens. Conclusions Interfascial dissection between two layers of deep temporal fascia through the intermediate fat pad is superior to other approaches because of the lack of facial nerve branches in this plane. The Intermediate fat could be easily separated from deep layer of deep temporal fascia.
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Affiliation(s)
- Rakesh K Sihag
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil K Gupta
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Daisy Sahni
- Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Aggarwal
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Hudise JY, Aldhabaan SA, Alqabbani AA, Nassar RS, Alarfaj AM. Tubed Temporalis Fascia for Nasal Dorsal Contouring: A Novel Technique. ORL J Otorhinolaryngol Relat Spec 2021; 83:97-103. [PMID: 33582670 DOI: 10.1159/000512528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/19/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Nasal dorsum irregularities may occur after nasal trauma or as a postrhinoplasty complication. Here, we present a novel technique using temporalis fascia (TF) grafting for primary and revision rhinoplasty to repair the nasal dorsum, hide nasal irregularities, and improve nasal contouring. METHODS This prospective cohort study was conducted from January 2019 to June 2019 and evaluated nasal dorsal contouring using the TF in a tubed form. The outcome variables were patient satisfaction, dorsal irregularity, and contour definition. The predictor variable was the use of tubed TF for dorsal augmentation. Other associated variables were age, sex, indication for surgery, surgery type, and graft size. Patient satisfaction was evaluated using the Rhinoplasty Outcome Evaluation questionnaire. A rhinoplasty specialist other than the surgeon who performed the procedure evaluated the dorsal augmentation outcomes by inspection and palpation of the dorsum. All statistical analyses were performed using the SPSS software. RESULTS Seventy-four patients (21.6% men and 78.4% women) were treated with the tubed TF. The mean age was 28.97 years. Thin skin was the most common indication (48.6%) for using TF. The graft size was 2-5 cm; inspection and palpation revealed no irregularities. No reception site complications occurred. One patient had a mild hematoma at the donor site. The mean patient satisfaction score was 10.14 preoperatively and 19.95 postoperatively (p = 0.001). DISCUSSION/CONCLUSIONS Our novel technique of using the TF graft in a tubed form was easy to perform. Furthermore, the tubed TF covers all irregularities, is good for dorsal augmentation, and improves dorsal contouring and definition.
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Affiliation(s)
- Jibril Y Hudise
- Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia, .,King Faisal Medical City for the Southern Regions, Abha, Saudi Arabia,
| | - Saud A Aldhabaan
- Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia.,King Faisal Medical City for the Southern Regions, Abha, Saudi Arabia
| | - Almaha A Alqabbani
- Department of Otolaryngology, Head and Neck Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Raad S Nassar
- Department of Otolaryngology, Head and Neck Surgery, Al-Habib Hospital, Riyadh, Saudi Arabia
| | - Ahmed M Alarfaj
- Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
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Abstract
Lipomas are common benign tumours that can occur in most parts of the body. Lipomas arising from the deep temporal fat pad, found between the two layers of the deep temporal fascia, are rare, however; there has been only one documented case report to our knowledge. We describe a second case arising from the temporal fat pad in a patient treated at our unit, having previously reported the first one, and discuss the relevant anatomy and management.
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Affiliation(s)
- J Davies
- Portsmouth Hospitals NHS Trust, UK
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Tarumoto S, Sugahara K, Hashimoto M, Hirose Y, Tsuda J, Takemoto Y, Fujii H, Matsuura T, Shimogori H, Ohgi J, Yamashita H. Effect of preservation on the physical and chemical properties of the temporal fascia. Auris Nasus Larynx 2020; 47:377-382. [PMID: 31983479 DOI: 10.1016/j.anl.2019.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/08/2019] [Accepted: 12/10/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The temporal fascia has been widely used in tympanoplasty. In addition, the preserved fascia has been also used in the ear surgery. In this study, we planned the experiments to determine whether physical and chemical properties of the fascia preserved at a low temperature. METHODS Preserved temporal fasciae from 21 patients were used in this study. The thickness of the temporal fascia was measured under a 3D laser microscope. The tensile strength was evaluated using a tensile tester. In addition, the chemical property evaluated was the biologic antioxidative potential of samples. RESULTS The results showed that the strength of the fascia was not affected by the retention period. The thick fascia tended to show the less tensile strength. The intensity was highest in middle-aged donors when compared to young and older donor. The antioxidative potentials did not affect the preservation. CONCLUSION The results suggested that the preserved temporal fascia could be safely used for tympanoplasty.
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Affiliation(s)
- Shunsuke Tarumoto
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
| | - Kazuma Sugahara
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
| | - Makoto Hashimoto
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
| | - Yoshinobu Hirose
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
| | - Junko Tsuda
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
| | - Yosuke Takemoto
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
| | - Hironori Fujii
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
| | - Takafumi Matsuura
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
| | - Hiroaki Shimogori
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
| | - Junji Ohgi
- Department of Medical Mechanical Engineering, Yamaguchi University Graduate School of Science and Engineering, 2-16-1 Tokiwadai Ube, Yamaguchi 755-8611, Japan
| | - Hiroshi Yamashita
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
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Solmaz F, Akduman D, Haksever M. Tri-layer Tympanoplasty as a New Technique in High-risk Tympanic Membrane Perforations. Iran J Otorhinolaryngol 2019; 31:259-265. [PMID: 31598492 PMCID: PMC6764813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The eradication of the middle ear disease is mentioned as the fundamental principle of tympanoplasty. The presence of some factors related to patient or disease itself forces the physician to classify the chronic ear disease as high-risk perforations. The aim of this study was to present a tri-layer tympanoplasty technique and its otological and audiological outcomes in the ears with high-risk perforations. MATERIALS AND METHODS This retrospective study was carried out on a total of 46 eligible ears that had chronic otitis media with high-risk perforations. Preoperatively, 17, 15, and 14 ears were reported with Sade classification grade 4 pars tensa retraction (Group 1), total or near-total tympanic membrane perforation (Group 2), and a history of ear surgery (Group 3), respectively. All the cases had tympanoplasty using the tri-layer technique at a tertiary center during 2008 and 2014. A review of the patients' chart showed that 46 patients underwent tri-layer tympanoplasty. Regarding the audiological outcomes, the comparison of pre- and post-operative results revealed mean air conduction level and mean air-bone gap (ABG) of 4 different frequencies in dB according to a new standardized format for reporting hearing outcome in clinical trials. RESULTS The mean value of the follow-up period was reported as 29.22±3.23 months. Graft take rate was 93.4 % in all the cases, as well as 94.1%, 100%, and 85.7% in Group 1, Group 2, and Group 3, respectively. The mean values of ABG were improved from 35.17±6.64 to 23.52±10.4, 30.46±5.89 to 17.20±8.04, and 29.14±8.37 to 16.14±5.02 dB in Group 1, Group 2, and Group 3, respectively (P<0.05). CONCLUSION Tri-layer tympanoplasty is a reliable procedure in the surgical treatment of the chronic otitis media with high-risk re-perforations.
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Affiliation(s)
- Fevzi Solmaz
- Department of Otorhinolaryngology, Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital,16800 Yıldırım, Bursa, Turkey.,Corresponding Author: Department of Otorhinolaryngology, Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital,16800 Yıldırım, Bursa, Turkey. Tel: +90 224 2955000, E-mail:
| | - Davut Akduman
- Department of Otorhinolaryngology, Duzce University Hospital, Duzce, Turkey.
| | - Mehmet Haksever
- Department of Otorhinolaryngology, Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital,16800 Yıldırım, Bursa, Turkey.
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