Arch Craniofac Surg.  2018 Jun;19(2):94-101. 10.7181/acfs.2018.01781.

Temporal augmentation with calvarial onlay graft during pterional craniotomy for prevention of temporal hollowing

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea. lkjhpl@hanmail.net
  • 2Department of Neurosurgery, Bundang Cha General Hospital, Seongnam, Korea.

Abstract

BACKGROUND
Atrophy of muscle and fat often contributes to temporal hollowing after pterional craniotomy. However, the main cause is from the bony defect. Several methods to prevent temporal hollowing have been introduced, all with specific limitations. Autologous bone grafts are most ideal for cranial defect reconstruction. The authors investigated the effectiveness of bony defect coverage and temporal augmentation using pterional craniotomy bone flap.
METHODS
This study was conducted in 100 patients who underwent brain tumor excision through pterional approach from 2015 to 2016. Group 1 underwent pterional craniotomy with temporal augmentation and group 2 without temporal augmentation. In group 1, after splitting the calvarial bone at the diploic space, the inner table was used for covering the bone defect and as an onlay graft for temporal augmentation. The outcome is evaluated by computed tomography at 1-year follow-up.
RESULTS
The mean operative time for temporal augmentation was 45 minutes. The mean follow-up was 12 months. The ratio of temporal thickness of operated side to non-operated side was 0.99 in group 1 and 0.44 in group 2, which was statistically different. The mean visual analogue scale score was 1.77 in group 1 and 6.85 in group 2.
CONCLUSION
This study demonstrated a surgical technique using autologous bone graft for successfully preventing the temporal hollowing and improved patient satisfaction.

Keyword

Craniotomy; Bone transplantation; Temporal bone; Temporal muscle

MeSH Terms

Atrophy
Bone Transplantation
Brain Neoplasms
Craniotomy*
Follow-Up Studies
Humans
Inlays*
Operative Time
Patient Satisfaction
Temporal Bone
Temporal Muscle
Transplants*
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