Unduly extensive mandibular insertion of temporalis muscle: A case report

PURPOSE

Anomalous extensive attachment of temporalis muscle covering the mandibular incisure is rarely reported in literature. Such variations of temporalis muscle are of immense significance in operative procedures of maxillo-facial region, utilization of temporalis muscle fl ap and accurate interpretation of radiographs.

MATERIALS AND METHODS

Dissection of the head and neck region during the course of undergraduate teaching programme revealed unduly extensive attachment of temporalis muscle fibres in the left side in an adult Indian male cadaver. The temporal and infra-temporal regions were carefully dissected to delineate the temporalis muscle with special emphasis on the branches of maxillary artery and mandibular nerve. The morphological details of the temporalis muscle were recorded and appropriate photographs taken.

RESULTS

The mandibular notch was 3.1 cm wide. The extra fleshy fibres of the temporalis muscle completely occupied the mandibular notch and further descended for insertion onto the coronoid process, and external and internal surfaces of the ramus of mandible. The masseteric nerves and vessels pierced the anomalous fibres of temporalis muscle in the mandibular notch.

CONCLUSION

The present study highlights the morphological details of an unduly extensive attachment of temporalis muscle and discusses its importance in reconstructive procedures of maxillo-facial region. Detailed information of the variations of temporalis muscle is also important in accurate interpretation of modern imaging procedures.

Temporomandibular region in the Franceschetti's Syndrome. Anatomical study

Franceschetti's syndrome is a rare, non-fatal, hereditary malformation, usually bilateral, which symmetrically affects orbits, mandible and ear. The authors propose an anatomical description of the temporomandibular region after the dissection of a newborn baby suffering from Franceschetti's Syndrome, dead soon after the birth. A discussion on the different etiopathogenical theories is made. The authors conclude that an alteration of the development of nerve trigeminal branches is the cause of the malformations.

The hourglass facial deformity

The "Hourglass Facial Deformity" is the result of bilateral irradiation of the orbits and anterior cranial base during infancy. The deformity is uniformly characterized by a distinctly misshapen upper face at the level of the orbits, with depression of the temporal region, hypotelorism, and flattened nasal root. These patients exhibited varying degrees of frontal bossing. Since they had previous enucleation, the orbital soft-tissue can be dissected off the eye socket, lateral orbital walls, and if necessary, the orbital cone, through a bicoronal incision. The deformity is then easily corrected with implantation of acrylic alloplastic material. Four cases are presented which had varying degrees of the same deformity and were successfully corrected using the operative procedure described. No complications have been encountered. Two patients required eye socket revisions.