Method to improve cosmetic outcome following craniotomy

Sato, Shuzo; Sato, Minako; Nishizawa, Manabu; Oizumi, Taro; Hiwatari, Masao; Kajiwara, Toshio; Ishikawa, Mami; Inamasu, George; Kawase, Takeshi

doi:10.1179/016164101101198721

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…Thus, neurosurgeons should get used to considering the aesthetic aspect as a necessity for all patients, even those with undesirable injuries. Therefore, a surgical protocol, regardless of the location and nature of the lesion, should be used to minimize the aesthetic effect with a step-bystep method [4][5][6][7][8]. One of the inevitable complications of scalp incision is scarring and loss of hair follicles in the cut area.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, a surgical protocol, regardless of the location and nature of the lesion, should be used. It is recommended to minimize the aesthetic effect with a step-by-step method [4][5][6][7][8]. Since paying attention to the aesthetic aspects of the patient's head after surgery is very important for the patient's mental health and social life, surgeons should try to adopt a method that minimizes damage to the scalp and follicles, heals the wound as soon as possible and reduces the extent of the incision area [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cosmetic Outcomes of Scalp in Standard Reverse Question Mark Incision and L.G. Kempe Incision in Large Craniotomies

2020

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Background and Aim: Craniotomy is a surgery in which a flap of the skull is opened to access the affected area in the brain. Since paying attention to the aesthetic aspects of the patient’s head after surgery is very important for the patient’s mental health and social life, surgeons should try to adopt a method that minimizes damage to the scalp and follicles. Methods and Materials/Patients: In this clinical trial study, patients who were candidates for frontotemporoparietal craniotomy surgery were selected. Twenty-three selected patients were randomly divided into 2 groups consisting of a 12-member intervention group (L.G. Kempe) and an 11-member control group (Standard Reverse Question mark). Patients underwent a pre-operative biopsy of the scalp and a follow-up biopsy 6 months post-operatively. In the evaluation of aesthetic aspects, the created scar was scored using the Stony Brook Scar Evaluation Scale (SBSES). Patients were also directly asked about their satisfaction with the operation and the scar created. Results: In 23 patients, the results showed that patients who underwent LG Kempe incision craniotomy received significantly higher scores in SBSES scoring evaluations (P=0.005). There was no significant difference in subjective evaluations by asking patients about their satisfaction with the scar site and the operation area (P=0.75). In the analysis of post-operative hair follicle density between the 2 groups (P=0.910), general changes in pre-operative and post-operative follicle density in all samples (P= 0.657) as well as comparing the changes between 2 groups, no significant difference was found between follicular density changes between the intervention and control groups (P=0.137). Conclusion: Patients treated with L.G. Kempe incision had significantly higher SBSES scores, which can be considered an aesthetically superior method that could prevent the formation of undesirable scar.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cosmetic Outcomes of Scalp in Standard Reverse Question Mark Incision and L.G. Kempe Incision in Large Craniotomies

2020

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“…Cosmetic problems following craniotomies sometimes occur due to burr holes or bone defects [1,2] . Autologous bone flap resorption is also a well-known cranioplasty complication after decompressive craniectomy [5][6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

“…After neurological surgeries, cosmetic problems following craniotomies sometimes occur, such as scalp depression over burr holes or bone defects [1,2] . Titanium plates or artificial bones are used in consideration of such cosmetic problems [3,4] .…”

Section: Introductionmentioning

confidence: 99%

Skull Subsidence due to Periosteum Defect following Craniotomy in a Child

Arishima

Akazawa²,

Kikuta³

2016

Pediatr Neurosurg

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We report a case of a 7-year-old child with a cranial deformity secondary to a craniotomy for an intracranial hematoma. He suffered from an acute epidural hematoma with a lineal fracture of the right temporal bone following a severe head injury. A large question mark-shaped skin flap with the periosteum and temporal muscle was created for a decompressive craniectomy; however, neither the acute epidural hematoma nor brain swelling was severe, and we performed a small craniotomy compared with the skin flap without a decompressive craniectomy. Eighteen months after the operation, he complained of skull deformity with a mild depression of the forehead. Axial and 3-dimensional computed tomography showed thinness and subsidence of the frontoparietal bone around the replaced bone flap, corresponding to the skin flap with the periosteum defect. We suggest that the periosteum defect following creation of the skin flap during surgery prevented normal growth of the skull, which caused the thinness and subsidence of the frontoparietal bone. Preservation and cooptation of the periosteum should be performed during neurological surgeries in babies and children to prevent skull deformity.

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“…The surgery can lead to aesthetic damage due to cutaneous scaring, depression of the skin, irregularity of the skin above the craniotomy, or subcutaneous breaks due to the materials lying underneath [2]. Patient satisfaction with the aesthetic outcome after craniotomy has only been sparsely investigated [2][3][4], however, making it difficult for the surgeon to optimize this part of the surgical procedure.…”

Section: Introductionmentioning

confidence: 99%