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J Neurol Surg B Skull Base 2022; 83(05): 554-558
DOI: 10.1055/s-0041-1741005
Original Article

Effects of Modified Osteoplastic Pterional Craniotomy on Temporal Muscle Volume and Frontal Muscle Nerve Function

Mehmet Seçer
1   Department of Neurosurgery, Alaaddin Keykubat University School of Medicine, Alanya, Antalya, Turkey
,
İsa Çam
2   Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey
,
Aykut Gökbel
3   Derince Training and Research Hospital Neurosurgery Clinic, Kocaeli, Turkey
,
Murat Ulutaş
4   Department of Neurosurgery, Harran University School of Medicine, Şanlıurfa, Turkey
,
Özgür Çakır
2   Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey
,
Anıl Ergen
5   Department of Neurosurgery, Kocaeli University School of Medicine, Kocaeli, Turkey
,
Kadir Çınar
6   Department of Neurosurgery, Sanko University, School of Medicine, Konukoglu Hospital, Gaziantep, Turkey
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Abstract

Introduction Pterional craniotomy is a surgical approach frequently used in aneurysm and skull base surgery. Pterional craniotomy may lead to cosmetic and functional problems, such as eyebrow drop due to facial nerve frontal branch damage, temporal muscle atrophy, and temporomandibular joint pain. The aim was to compare the postoperative effects of our modified osteoplastic craniotomy with classical pterional craniotomy in terms of any change in volume of temporal muscle and in the degree of frontal muscle nerve damage.

Materials and Methods Aneurysm cases were operated with either modified osteoplastic pterional craniotomy or free bone flap pterional craniotomy according to the surgeon's preference. Outcomes were compared in terms of temporal muscle volume and frontal muscle nerve function 6 months postoperatively.

Results Preoperative temporal muscle volume in the modified osteoplastic pterional and free bone flap pterional craniotomy groups were not different (p > 0.05). However, significantly less atrophy was observed in the postoperative temporal muscle volume of the osteoplastic group compared with the classical craniotomy group (p < 0.001). In addition, when comparing frontal muscle nerve function there was less nerve damage in the modified osteoplastic pterional craniotomy group compared with the classical craniotomy group, although this did not reach significance (p > 0.05).

Conclusion Modified osteoplastic pterional craniotomy significantly reduced atrophy of temporal muscle and caused proportionally less frontal muscle nerve damage compared with pterional craniotomy, although this latter outcome was not significant. These findings suggest that osteoplastic craniotomy may be a more advantageous intervention in cosmetic and functional terms compared with classical pterional craniotomy.

Keywords

aneurysm - modified osteoplastic pterional craniotomy - pterional craniotomy - temporal muscle volume

Note

The manuscript submitted does not contain information about medical device(s)/drug(s).




Publication History

Received: 08 December 2020

Accepted: 12 November 2021

Article published online:
29 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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