Faisal Ashfaq, Mabroor Ahmed Bhatty.
Modified temporalis muscle transfer for paralytic lagophthalmos in leprosy patients.
Med Channel Jan ;17(3):5-8.

Background: Leprosy is still a problem in Pakistan. In Head and neck region, it causes facial nerve paralysis. Involvement of orbicularis oculi causes significant disability and restoring its function surgically becomes very important. Temporalis muscle transfer is a popular dynamic procedure for paralytic lagophthalmos. We describe surgical technique and results of modified temporalis muscle transfer to correct this problem obviating the problems associated with classic transfer. Methods: Medical records of eight patients treated with this transfer from January 2007 to September 2010 in Marie Adelaide Leprosy centre, Karachi were studied. In all patients diagnosis was clinical. Temporalis was functionally intact before surgery was contemplated. Results: There were seven men and one woman. Mean age at time of presentation was 41.7 years. Mean duration of leprosy was 10 years ranging from 3-30 years. Seven patients achieved satisfactory eye closure with resolution of epiphora and corneal irritation. Only one patient needed revision surgery and was satisfied after revisional surgery. None of patients had contour abnormalities in the region of temporal fossa. Conclusion: Modified temporalis muscle transfer is less extensive, well tolerated especially in elderly, and can achieve good functional results.

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