Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Effectiveness of Temporal Augmentation Using a Calvarial Onlay Graft during Pterional Craniotomy

  • Kim, Yoon Soo (Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine) ;
  • Yi, Hyung Suk (Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine) ;
  • Kim, Han Kyu (Department of Neurosurgery, Bundang Jesaeng General Hospital) ;
  • Han, Yea Sik (Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine)
  • Received : 2015.08.19
  • Accepted : 2016.03.04
  • Published : 2016.03.18
Download PDF
⟨ Previous Next ⟩

Abstract

Temporal hollowing occurs to varying degrees after pterional craniotomy. The most common cause of temporal hollowing is a bony defect of the pterional and temporal regions due to the resection of the sphenoid ridge and temporal squama for adequate exposure without overhang. The augmentation of such bony defects is important in preventing craniofacial deformities and postoperative hollowness. Temporal cranioplasty has been performed using a range of materials, such as acrylics, porous polyethylene, bone cement, titanium, muscle flaps, and prosthetic dermis. These methods are limited by the risk of damage to adjacent tissue and infection, a prolonged preparation phase, the possibility of reabsorption, and cost inefficiency. We have developed a method of temporal augmentation using a calvarial onlay graft as a single-stage neurosurgical reconstructive operation in patients requiring craniotomy. In this report, we describe the surgical details and review our institutional outcomes. The patients were divided into pterional craniotomy and onlay graft groups. Clinical temporal hollowing was assessed using a visual analog scale (VAS). Temporal soft tissue thickness was measured on preoperative and postoperative computed tomography (CT) studies. Both the VAS and CT-based assessments were compared between the groups. Our review indicated that the use of an onlay graft was associated with a lower VAS score and left-right discrepancy in the temporal contour than were observed in patients undergoing pterional craniotomy without an onlay graft.

Keywords

References

  1. Choudhry OJ, Christiano LD, Arnaout O, et al. Reconstruction of pterional defects after frontotemporal and orbitozygomatic craniotomy using Medpor Titan implant: cosmetic results in 98 patients. Clin Neurol Neurosurg 2013;115:1716-20. https://doi.org/10.1016/j.clineuro.2013.03.014
  2. Matsumoto K, Akagi K, Abekura M, et al. Cosmetic and functional reconstruction achieved using a split myofascial bone flap for pterional craniotomy: technical note. J Neurosurg 2001;94:667-70. https://doi.org/10.3171/jns.2001.94.4.0667
  3. Rapidis AD, Day TA. The use of temporal polyethylene implant after temporalis myofascial flap transposition: clinical and radiographic results from its use in 21 patients. J Oral Maxillofac Surg 2006;64:12-22.
  4. Badie B. Cosmetic reconstruction of temporal defect following pterional [corrected] craniotomy. Surg Neurol 1996;45: 383-4. https://doi.org/10.1016/0090-3019(95)00452-1
  5. Kadri PA, Al-Mefty O. The anatomical basis for surgical preservation of temporal muscle. J Neurosurg 2004;100:517-22. https://doi.org/10.3171/jns.2004.100.3.0517
  6. Oikawa S, Mizuno M, Muraoka S, et al. Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy: technical note. J Neurosurg 1996;84: 297-9. https://doi.org/10.3171/jns.1996.84.2.0297
  7. Spetzler RF, Lee KS. Reconstruction of the temporalis muscle for the pterional craniotomy: technical note. J Neurosurg 1990;73:636-7. https://doi.org/10.3171/jns.1990.73.4.0636
  8. Appell HJ, Gloser S, Duarte JA, et al. Skeletal muscle damage during tourniquet-induced ischaemia. The initial step towards atrophy after orthopaedic surgery? Eur J Appl Physiol Occup Physiol 1993;67:342-7. https://doi.org/10.1007/BF00357633
  9. Miyazawa T. Less invasive reconstruction of the temporalis muscle for pterional craniotomy: modified procedures. Surg Neurol 1998;50:347-51. https://doi.org/10.1016/S0090-3019(97)00345-5
  10. Ammirati M, Spallone A, Ma J, et al. An anatomicosurgical study of the temporal branch of the facial nerve. Neurosurgery 1993;33:1038-43. https://doi.org/10.1227/00006123-199312000-00012
  11. Brunori A, DiBenedetto A, Chiappetta F. Transosseous reconstruction of temporalis muscle for pterional craniotomy: technical note. Minim Invasive Neurosurg 1997;40:22-3. https://doi.org/10.1055/s-2008-1053408
  12. Matic DB, Kim S. Temporal hollowing following coronal incision: a prospective, randomized, controlled trial. Plast Reconstr Surg 2008;121:379e-385e. https://doi.org/10.1097/PRS.0b013e318170724c
  13. Steinbacher DM, Wink J, Bartlett SP. Temporal hollowing following surgical correction of unicoronal synostosis. Plast Reconstr Surg 2011;128:231-40. https://doi.org/10.1097/PRS.0b013e318218fcab

Cited by

  1. Comparative Cost Analysis of Single and Mutli-Stage Temporal Deformity Correction Following Neurosurgical Procedures vol.29, pp.1, 2016, https://doi.org/10.1097/scs.0000000000004107
  2. Cosmetic Reconstruction of Frontotemporal Depression Using Polyethylene Implant after Pterional Craniotomy vol.2018, pp.None, 2016, https://doi.org/10.1155/2018/1982726
  3. Temporal augmentation with calvarial onlay graft during pterional craniotomy for prevention of temporal hollowing vol.19, pp.2, 2016, https://doi.org/10.7181/acfs.2018.01781
  4. Post-Neurosurgical Temporal Deformities: Various Techniques for Correction and Associated Complications vol.29, pp.7, 2018, https://doi.org/10.1097/scs.0000000000004639
  5. Cranial Suture Anchor Temporalis Resuspension : A New Technique to Reconstruct Temporal Hollowing After Craniotomy vol.30, pp.6, 2016, https://doi.org/10.1097/scs.0000000000005500
  6. Accuracy of patient-specific temporal implants using PEKK vol.49, pp.10, 2016, https://doi.org/10.1016/j.jcms.2021.05.001