The utilization of teres major muscle in facial paralysis reanimation: an anatomic study

This study explores vascular and morphologic anatomy of the teres major muscle, which can be an alternative to donor muscles used in functional muscle transfer in long-standing facial paralysis reanimation. A total of 14 teres major muscles from 7 embalmed cadavers were dissected and examined. Diameters and lengths of major and minor arteries supplying the muscle, venous pedicle diameter, neural pedicle diameter and length, their entrances into the muscle, the extendibility of neurovascular pedicles, when necessary, and the morphology of muscle were evaluated. Mean results obtained for teres major muscle in the study were as follows: the longest distance between the starting point and the area where the tendon started was 17.1 +/- 0.34 cm (range, 14.5-18.8 cm), the distance between the widest points was 5.8 +/- 0.5 cm (range, 5.1-6.2 cm), the thickest area was 3.4 +/- 0.9 cm (range, 2.8-3.9 cm), and surface area was 58.2 +/- 1.02 cm2 (range, 48.1-62.7 cm2). The major pedicle of the muscle, which is type 2 according to Mahtnes-Nahai classification, has a length of 3.0 +/- 0.6 cm (range, 2.4-3.6 cm) and a diameter of 2.7 +/- 0.21 mm (range, 1.85-3.4 mm). The nerve that provides motor innervation to the muscle is 5.9 cm (range, 4.1-9.9 cm) in length and 1.7 mm (range, 1.2-2.5 mm) in diameter. As a result of this preliminary study, we think that morphologic and neurovascular structures of this muscle is suitable for use in long-standing facial paralysis reanimation.