Arch Plast Surg.  2016 Mar;43(2):204-209. 10.5999/aps.2016.43.2.204.

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

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea. hanplastic1@naver.com
  • 2Department of Neurosurgery, Bundang Jesaeng General Hospital, Seongnam, Korea.

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.

Keyword

Craniotomy; Bone transplantation; Temporal bone

MeSH Terms

Bone Transplantation
Congenital Abnormalities
Craniotomy*
Dermis
Humans
Inlays*
Polyethylene
Temporal Bone
Titanium
Transplants*
Visual Analog Scale
Polyethylene
Titanium
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