Cryptogenic Temporal Hollowing

Park, Ie Hyon; Kwon, Heeyeon; Kim, Sang Wha

doi:10.7181/acfs.2016.17.4.218

Cited by 3 publications

(5 citation statements)

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“…Other causes of temporal contour deformity and enlargement have also been reported 19–22,25,35 . Lisiecki et al 21 investigated temporal soft tissue volumes of 26 patients with Treacher Collins syndrome and 28 patients with Pierre Robin sequence.…”

Section: Discussionmentioning

confidence: 96%

“…Other causes of temporal contour deformity and enlargement have also been reported. [19][20][21][22]25,35 Lisiecki et al 21 investigated temporal soft tissue volumes of 26 patients with Treacher Collins syndrome and 28 patients with Pierre Robin sequence. Using a similar methodology and software to the 1 in our study, patients with these conditions had significantly decreased measures of TM and TF pad when compared to an age-matched control group.…”

Section: Discussionmentioning

confidence: 99%

“…Contour irregularities in the temporal region have been reported secondary to aging, craniofacial trauma, surgical trauma that involve temporal dissection, medications, and certain medical condition and craniofacial syndromes such as Apert, Treacher-Collins, Pierre-Robins, and Romberg 3,11,13,19–24 . Most of them discussed the temporal contour deformity, which is referred as the concavity or depression of the temporal region that results from either an increase in the skeletal dimensions or a decrease in the volume of TM or STFP, 3,11,13,20,21,23–27 whereas few discussed the temporal enlargement 19,22 . Notably, atrophy of TM and/or STFP has been long attributed as the underlying cause of temporal hollowing that is observed after frontotemporal craniotomies.…”

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confidence: 99%

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Paradoxical Temporal Enlargement: An Expansion of Superficial Temporal Fat Pad Following Interfacial Technique for Pterional Craniotomy

Krug

Kuruoglu

Yan

et al. 2021

Journal of Craniofacial Surgery

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Objective: Contour irregularities in the temporal region have been reported previously after procedures involving temporal dissection. In this study, we report paradoxical temporal enlargement (PTE) following interfascial pterional craniotomy. Methods: A retrospective review of patients who underwent a unilateral transcranial procedure with frontotemporal approach at our institution between September 2013 and December 2017 was performed. Patients with a previous craniotomy or bilateral craniotomy were excluded. Radiological imaging series including computed tomography and magnetic resonance imaging were utilized to calculate temporal soft tissue volumes both preoperatively and postoperatively by using advanced software technology. Relative soft tissue volume differences between the operative side and the contralateral side were calculated at different time-points including preoperative, 3-months follow-up (3M), 12-months (12M) follow-up, and the last follow-up (LFU, over 1-year). Results: Forty-three patients were included. Mean age was 52.7 AE 4.5 years. Mean follow-up was 27.9 AE 15.8 months. Significant changes of temporal fat pad relative-volume difference were observed between the preoperative and the corresponding 3M (t [82] ¼ À2.8865, P ¼ 0.0050); 12M (t [77] ¼ À4.4321, P < 0.0001), and LFU (t [74] ¼ À4.9862, P < 0.0001) postoperative time points. No significant change of the temporalis muscle was observed between the preoperative and the corresponding 3M (P ¼ 0.3629), 12M (P ¼ 0.1553), or LFU (P ¼ 0.0715). Soft tissue volume showed a significant increase on the operative side between the preoperative and the corresponding LFU (t [74] ¼ À2.5866, P ¼ 0.0117).Conclusions: Paradoxical temporal enlargement with more than 10% volumetric change was observed in 24% of the patients at their LFU (>1-year). This change was not due to temporalis muscle changes. Paradoxical temporal enlargement was due to hypertrophy of the superficial temporal fat pad. Before surgical correction of postoperative temporal contour changes, it is important to obtain imaging and characterize the etiology of the deformity.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Paradoxical Temporal Enlargement: An Expansion of Superficial Temporal Fat Pad Following Interfacial Technique for Pterional Craniotomy

Krug

Kuruoglu

Yan

et al. 2021

Journal of Craniofacial Surgery

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“…Postoperative temporal hollowing is a depression in the temporal region that can occur after cranial surgery. It is the result of atrophy of the superficial temporal fat pad (caused by ischemia or denervation) and disinsertion or atrophy of the temporalis muscle [1].…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative temporal hollowing can occur after craniectomy or cranioplasty for intracranial hemorrhage [1,2]. This complication can be caused by the disinsertion or displacement of the temporalis muscle and atrophy of the superficial temporal fat pad [3].…”

Section: Introductionmentioning

confidence: 99%

Correction of postoperative temporal hollowing using a combination of thread-lift and autologous fat graft: a case report

Sung

Kim

2023

Arch Aesthetic Plast Surg

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Postoperative temporal hollowing is a complication that can occur after craniectomy or cranioplasty. It is caused by the disinsertion or displacement of the temporalis muscle and atrophy of the superficial temporal fat pad. We introduce a case of temporal hollowing correction using polydioxanone thread-lifting and fat grafts. A 28-year-old man presented with right temporal hollowing and asymmetric bulging of the zygomatic region. The patient wanted an aesthetically favorable correction with a short recovery period, without using a permanent implant. We performed a two-stage procedure. In the first stage, 21 mL of centrifuged fat was obtained, of which 7 mL was injected into the temporal region. A month later, another 4 mL of the stored fat was injected, and thread-lifting was performed through the temporal region after identifying the deep temporal fascia. Four threads were inserted, pulled toward the entry point, and tied. The anchoring of the thread-lifted tissue remained stable, and the volume of grafted fat was well preserved at the 4-month follow-up. The patient was satisfied with the cosmetic results. In this case, temporal hollowing was effectively managed with fat grafting and thread lifting. We recommend this method as an option for reconstruction of temporal hollowing with a short recovery period and high patient satisfaction.

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Functional and Esthetic Outcomes of Either Surgically or Conservatively Treated Anterior Frontal Sinus Wall Fractures: A Long-Term Follow-Up

Solmell,

Sunnergren,

Qureshi

et al. 2024

Craniomaxillofacial Trauma & Reconstruction

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Study Design Retrospective cohort study. Objective Frontal sinus fractures (FSFs) can lead to a range of clinical challenges, including facial deformity, impaired facial sensation, cerebrospinal fluid (CSF) leakage, sinus drainage impairment, chronic sinus pain and mucocele formation. The optimal management approach, whether surgical or conservative, remains a topic of ongoing discussion. The aim of this study was to evaluate and compare the functional and esthetic outcomes of patients with surgically and conservatively treated FSFs. Methods In this retrospective study, patients treated for FSFs at the Karolinska university hospital 2004 to 2020 were identified in hospital records and invited to participate in a long-term follow-up. Sequelae and satisfaction with the esthetic result were assessed trough questionnaires and physical examinations. Results A total of 93 patients were included in the study, with 49 presenting isolated anterior wall fractures and 44 presenting combined anterior and posterior wall fractures. Surgical intervention was performed in 45 cases, while 48 were managed conservatively. Among patients with moderate anterior wall fractures (4-6 mm dislocation), 80% of surgically treated patients compared to 100% of conservatively treated patients expressed satisfaction with their cosmetic outcomes at follow-up ( P = .03). In conservatively treated patients with a forehead impression, the anterior wall fracture dislocation ranged from 5.3 to 6.0 mm ( P < .0001). Approximately 50% of surgically treated patients vs 15% of conservatively treated patients developed impaired forehead sensation at follow-up ( P = .03). Thirty-six percent of surgically treated patients reported dissatisfaction with surgery-related scarring, particularly those who underwent surgery via laceration or bicoronal incision. Conclusions This study suggests that anterior FSFs with a dislocation of 5 mm or less can be effectively managed conservatively with high patient satisfaction, low risk of long-term forehead sensation impairment and without potential development of forehead impression. Bicoronal incision or incision via a laceration may be associated with esthetic dissatisfaction and late sequelae such as alopecia.

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Cryptogenic Temporal Hollowing

Cited by 3 publications

References 5 publications

Paradoxical Temporal Enlargement: An Expansion of Superficial Temporal Fat Pad Following Interfacial Technique for Pterional Craniotomy

Paradoxical Temporal Enlargement: An Expansion of Superficial Temporal Fat Pad Following Interfacial Technique for Pterional Craniotomy

Correction of postoperative temporal hollowing using a combination of thread-lift and autologous fat graft: a case report

Functional and Esthetic Outcomes of Either Surgically or Conservatively Treated Anterior Frontal Sinus Wall Fractures: A Long-Term Follow-Up

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