Limits...
A Simple Method for Reconstruction of the Temporalis Muscle Using Contourable Strut Plate after Pterional Craniotomy: Introduction of the Surgical Techniques and Analysis of Its Efficacy.

Park JH, Lee YS, Suh SJ, Lee JH, Ryu KY, Kang DG - J Cerebrovasc Endovasc Neurosurg (2015)

Bottom Line: Lower incidences of ID of the muscle (p < 0.001), DTL (p < 0.001), and PITF (p = 0.001) were observed in the MC + CSP than in the MC Only group.The incidence of acceptable outcome was markedly higher in the MC + CSP group (p < 0.001).ID was regarded as a causative factor for DTL and PITF (p < 0.001 in both).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.

ABSTRACT

Objective: Pterional craniotomy (PC) using myocutaneous (MC) flap is a simple and efficient technique; however, due to subsequent inferior displacement (ID) of the temporalis muscle, it can cause postoperative deformities of the muscle such as depression along the inferior margin of the temporal line of the frontal bone (DTL) and muscular protrusion at the inferior portion of the temporal fossa (PITF). Herein, we introduce a simple method for reconstruction of the temporalis muscle using a contourable strut plate (CSP) and evaluate its efficacy.

Materials and methods: Patients at follow-ups between January 2014 and October 2014 after PCs were enrolled in this study. Their postoperative deformities of the temporalis muscle including ID, DTL, and PITF were evaluated. These PC cases using MC flap were classified according to two groups; one with conventional technique without CSP (MC Only) and another with reconstruction of the temporalis muscle using CSP (MC + CSP). Statistical analyses were performed for comparison between the two groups.

Results: Lower incidences of ID of the muscle (p < 0.001), DTL (p < 0.001), and PITF (p = 0.001) were observed in the MC + CSP than in the MC Only group. The incidence of acceptable outcome was markedly higher in the MC + CSP group (p < 0.001). ID was regarded as a causative factor for DTL and PITF (p < 0.001 in both).

Conclusion: Reconstruction of the temporalis muscle using CSP after MC flap is a simple and efficient technique, which provides an outstanding outcome in terms of anatomical restoration of the temporalis muscle.

No MeSH data available.


Related in: MedlinePlus

Three-dimensional computed tomography (CT) scans (A, B) of a patient after reconstruction of the temporalis muscle using a contourable strut plate (CSP) (black asterisk) show anatomical restoration of the temporalis muscle at the temporal line (white arrowheads). A photograph (C) of the same patient shows an outstanding outcome without any deformities of the temporalis muscle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4495087&req=5

Figure 5: Three-dimensional computed tomography (CT) scans (A, B) of a patient after reconstruction of the temporalis muscle using a contourable strut plate (CSP) (black asterisk) show anatomical restoration of the temporalis muscle at the temporal line (white arrowheads). A photograph (C) of the same patient shows an outstanding outcome without any deformities of the temporalis muscle.

Mentions: ID of the temporalis muscle was detected on the three-dimensional CT scans in 40 cases (37.7%); 40 (50%) in the MC Only group and none (0%) in the MC + CSP group, and the incidences were statistically different between the two groups (p < 0.001 by Fisher's exact test) (Fig. 2A, B). DTL was observed in 27 cases (25.5%); 27 (33.8%) in the MC Only group and none (0%) in the MC + CSP group, and the incidences were statistically different between the two groups (p < 0.001 by Fisher's exact test) (Fig. 2C). PITF was observed in 20 cases (18.9%); 20 (25%) in the MC Only group and none (0%) in the MC + CSP group, and the incidences were also statistically different (p = 0.001 by Fisher's exact test) (Fig. 2D-F). Fifty-one cases (63.8%) in the MC Only group and all 26 cases (100%) in the MC + CSP group did not have DTL and PITF regardless of presence of ID of the temporalis muscle on the CT scans, indicating absence of definite cosmetic deformities of the temporalis muscle (Fig. 5). The incidences of absence of the deformities were also statistically different (p < 0.001 by chi-square test) (Table 1).


A Simple Method for Reconstruction of the Temporalis Muscle Using Contourable Strut Plate after Pterional Craniotomy: Introduction of the Surgical Techniques and Analysis of Its Efficacy.

Park JH, Lee YS, Suh SJ, Lee JH, Ryu KY, Kang DG - J Cerebrovasc Endovasc Neurosurg (2015)

Three-dimensional computed tomography (CT) scans (A, B) of a patient after reconstruction of the temporalis muscle using a contourable strut plate (CSP) (black asterisk) show anatomical restoration of the temporalis muscle at the temporal line (white arrowheads). A photograph (C) of the same patient shows an outstanding outcome without any deformities of the temporalis muscle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4495087&req=5

Figure 5: Three-dimensional computed tomography (CT) scans (A, B) of a patient after reconstruction of the temporalis muscle using a contourable strut plate (CSP) (black asterisk) show anatomical restoration of the temporalis muscle at the temporal line (white arrowheads). A photograph (C) of the same patient shows an outstanding outcome without any deformities of the temporalis muscle.
Mentions: ID of the temporalis muscle was detected on the three-dimensional CT scans in 40 cases (37.7%); 40 (50%) in the MC Only group and none (0%) in the MC + CSP group, and the incidences were statistically different between the two groups (p < 0.001 by Fisher's exact test) (Fig. 2A, B). DTL was observed in 27 cases (25.5%); 27 (33.8%) in the MC Only group and none (0%) in the MC + CSP group, and the incidences were statistically different between the two groups (p < 0.001 by Fisher's exact test) (Fig. 2C). PITF was observed in 20 cases (18.9%); 20 (25%) in the MC Only group and none (0%) in the MC + CSP group, and the incidences were also statistically different (p = 0.001 by Fisher's exact test) (Fig. 2D-F). Fifty-one cases (63.8%) in the MC Only group and all 26 cases (100%) in the MC + CSP group did not have DTL and PITF regardless of presence of ID of the temporalis muscle on the CT scans, indicating absence of definite cosmetic deformities of the temporalis muscle (Fig. 5). The incidences of absence of the deformities were also statistically different (p < 0.001 by chi-square test) (Table 1).

Bottom Line: Lower incidences of ID of the muscle (p < 0.001), DTL (p < 0.001), and PITF (p = 0.001) were observed in the MC + CSP than in the MC Only group.The incidence of acceptable outcome was markedly higher in the MC + CSP group (p < 0.001).ID was regarded as a causative factor for DTL and PITF (p < 0.001 in both).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.

ABSTRACT

Objective: Pterional craniotomy (PC) using myocutaneous (MC) flap is a simple and efficient technique; however, due to subsequent inferior displacement (ID) of the temporalis muscle, it can cause postoperative deformities of the muscle such as depression along the inferior margin of the temporal line of the frontal bone (DTL) and muscular protrusion at the inferior portion of the temporal fossa (PITF). Herein, we introduce a simple method for reconstruction of the temporalis muscle using a contourable strut plate (CSP) and evaluate its efficacy.

Materials and methods: Patients at follow-ups between January 2014 and October 2014 after PCs were enrolled in this study. Their postoperative deformities of the temporalis muscle including ID, DTL, and PITF were evaluated. These PC cases using MC flap were classified according to two groups; one with conventional technique without CSP (MC Only) and another with reconstruction of the temporalis muscle using CSP (MC + CSP). Statistical analyses were performed for comparison between the two groups.

Results: Lower incidences of ID of the muscle (p < 0.001), DTL (p < 0.001), and PITF (p = 0.001) were observed in the MC + CSP than in the MC Only group. The incidence of acceptable outcome was markedly higher in the MC + CSP group (p < 0.001). ID was regarded as a causative factor for DTL and PITF (p < 0.001 in both).

Conclusion: Reconstruction of the temporalis muscle using CSP after MC flap is a simple and efficient technique, which provides an outstanding outcome in terms of anatomical restoration of the temporalis muscle.

No MeSH data available.


Related in: MedlinePlus