{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T04:29:27Z","timestamp":1741926567945,"version":"3.38.0"},"reference-count":21,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Temporal hollowing is a common cosmetic complication following pterional craniotomies. To address this issue, we evaluated the efficacy of anterior rotation of the temporalis muscle at closure. Although this technique is not new and has been generally reported, no research studies have been conducted to evaluate its objective and patient-reported outcomes in the long term.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We retrospectively reviewed 22 patients treated with pterional, fronto-orbitozygomatic, or frontotemporo-zygomatic craniotomies from March 2021 to 2023. A 12-month postoperative magnetic resonance imaging was used to evaluate the degree of temporal hollowing. To quantify temporal hollowing, we measured the distance of depression at the level of the temporal fossa. This distance, or \u201ctemporal thickness,\u201d was defined as the widest distance between the skull\u2019s outer cortical bone and skin surfaces at the level of the anterior clinoid process (D1) and foramen of Monro (D2). Furthermore, pre and postoperative cosmetic results were evaluated using the Rostock Functional and Cosmetic Cranioplasty (RFCC) Score. For reasons of objectivity, RFCC was tested by two independent plastic surgeons against the patient\u2019s rating.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results<\/jats:title>\n<jats:p>After a year or more follow-up, 54.5% of patients exhibited no hollowing, while 31.8% had mild or moderate hollowing. Moreover, 91% reported good esthetic outcomes. No cases of severe hollowing were observed. Importantly, temporomandibular joint dysfunction was not observed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>These results suggest that anterior rotation of the temporalis muscle is an effective primary strategy to mitigate cosmetic deformities without compromising masticatory function. Further studies with larger sample sizes are warranted to confirm these findings.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_895_2024","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T01:54:37Z","timestamp":1741917277000},"page":"90","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anterior rotation of the temporalis muscle for prevention of temporal hollowing in cranial surgeries: Esthetic and patient-reported outcomes"],"prefix":"10.25259","volume":"16","author":[{"given":"Ignacio J.","family":"Barrenechea","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital Privado de Rosario, Rosario, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micaela","family":"Clerici","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hospital Privado de Rosario, Rosario, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9sar","family":"Cordero Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hospital Privado de Rosario, Rosario, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"M\u00e1rquez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Privado de Rosario, Rosario, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina C.","family":"Miralles","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Hospital Privado de Rosario, Rosario, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernesto Adrian","family":"Moretti","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hospital Privado de Rosario, Rosario, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"10.25259\/SNI_895_2024\/ref-1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ijsu.2020.11.005","article-title":"The PROCESS 2020 guideline: Updating consensus preferred reporting of CasESeries in surgery (PROCESS) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int J Surg"},{"key":"10.25259\/SNI_895_2024\/ref-2","first-page":"450","article-title":"Temporalis muscle resuspension using titanium miniplates and screws: Technical note","volume":"48","author":"Barone","year":"2001","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_895_2024\/ref-3","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/S1042-3680(02)00029-3","article-title":"Hair sparing techniques and scalp flap design","volume":"13","author":"Camarata","year":"2002","journal-title":"Neurosurg Clin N Am"},{"key":"10.25259\/SNI_895_2024\/ref-4","doi-asserted-by":"crossref","first-page":"9523629","DOI":"10.1155\/2022\/9523629","article-title":"Correction of temporal hollowing deformity using serratus anterior muscle flap","volume":"2022","author":"Chang","year":"2022","journal-title":"Biomed Res Int"},{"key":"10.25259\/SNI_895_2024\/ref-5","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1016\/j.clineuro.2013.03.014","article-title":"Reconstruction of pterional defects after frontotemporal and orbitozygomatic craniotomy using Medpor Titan implant: Cosmetic results in 98 patients","volume":"115","author":"Choudhry","year":"2013","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_895_2024\/ref-6","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1590\/S0004-282X1998000200006","article-title":"Dysfunction of the temporalis muscle after pterional craniotomy for intracranial aneurysms. 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