Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy

Oikawa, Susumu; Mizuno, Masahiko; Muraoka, Shinsuke; Kobayashi, Shigeaki

doi:10.3171/jns.1996.84.2.0297

Cited by 139 publications

(83 citation statements)

References 6 publications

(3 reference statements)

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“…Thorough review of the literature reveals that not much has been written about rupture of the temporalis muscle insertion. Etiologies that have been described as a potential cause for injury include direct injury to the muscle fibers caused by inappropriate intra operative dissection or retraction [7][8][9][10] . Direct trauma such as a blow to the side of the head or a motor vehicle accident can also cause injury to the temporalis muscle.…”

Section: Discussionmentioning

confidence: 99%

Myotendinous rupture of temporalis muscle: A rare injury following seizure

Naffaa

Tandon

Rubin

2014

WJR

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Seizures are one of the most common pediatric neurologic disorders. Many complications secondary to seizures have been described in the literature including head trauma, fractures, drowning and burns. However, to the best of our knowledge, rupture of the myotendinous insertion of the temporalis muscle on the mandible secondary to a seizure has never been described in the literature. We report the case of a unilateral temporalis muscle rupture in a 16-year-old boy who developed unilateral facial swelling following new onset tonic-clonic seizures. We emphasize on the computed tomography and magnetic resonance imaging findings in this case report. Two mechanisms have been proposed to explain such an injury. The favored mechanism in our patient is a pull on the temporalis myotendinous insertion on the mandible following vigorous and brisk deviation of the head and neck during seizure. Radiologists should be familiar with this type of injury following seizures in order to prevent misdiagnosis and subsequently mistreatment. Key words: Seizure; Rupture; Temporalis; Muscle; Pediatric Core tip: We report the unique case of a unilateral temporalis muscle rupture following new onset tonic-clonic seizures in a 16-year-old boy. The favored mechanism in our patient is a pull on the temporalis myotendinous insertion on the mandible following vigorous and brisk deviation of the head and neck during seizure. Although this is a rare entity, it is important to be familiar with such type of injury in a patient who develops unilateral facial swelling and pain following tonic-clonic seizures in order to prevent misdiagnosis and mistreatment. Naffaa LN, Tandon YK, Rubin M. Myotendinous rupture of temporalis muscle: A rare injury following seizure. World J Radiol 2014; 6(6): 388-391 Available from:

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Section: Discussionmentioning

confidence: 99%

Myotendinous rupture of temporalis muscle: A rare injury following seizure

Naffaa

Tandon

Rubin

2014

WJR

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“…The need for a way to perform this craniotomy without a cut in the temporalis muscle is derived from the functional and cosmetic problems noticed in patients following this craniotomy. 8 Since its introduction, the pterional craniotomy and its modifications or extensions were used extensively all around the world. This approach, however, resulted in morbidity, mostly associated with damage to the frontal branch of the facial nerve and temporalis muscle atrophy.…”

Section: Discussionmentioning

confidence: 99%

The “Agnes Fast” Craniotomy: The Modified Pterional (Osteoplastic) Craniotomy

et al. 2011

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The ''Agnes Fast'' craniotomy is a fast and simple way of performing the pterional craniotomy while preserving the temporalis muscle, together with its fascia and bony attachment. Using this technique, the surgeon need not divide the temporalis muscle, separate it from its bony attachment, or perform an interfacial dissection. With a little practice, this craniotomy can be performed in less than 5 minutes and is highly recommended in emergent settings. The modified pterional craniotomy was performed in 10 cadaveric specimens, preserving the temporalis muscle with its attachment. An interfascial dissection was not performed while exposing the frontozygomatic process. The exposure gained, the length of the procedure, and the ease of application were recorded for all heads studied. In all heads studied, the Agnes Fast craniotomy was performed, with complete preservation of the temporalis muscle and its attachments. This procedure was performed quickly, with complete preservation of the fascial nerve and its branches. The muscle was put back in its natural place following the craniotomy. The Agnes Fast craniotomy offers a fast way of performing a pterional craniotomy while preserving the temporalis muscle, with its blood supply, neural innervation, bony attachment, and fascia intact. Replacing the muscle is also fast and simple and involves placement of two CranioFix (Aesculap, Inc., Center Valley, PA) holders to the bone, with no suture material. This approach does not limit the exposure gained and offers the same exposure as the ''usual'' pterional craniotomy.

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“…The skin flap was dissected between the galea aponeurotica and temporal fascia. The temporal muscle was dissected from the bone with a retrograde dissection technique (9,10), and the deep temporal artery (DTA) was easily preserved. A heart-like frontal-temporal bone flap was made along the superior temporal line, and the middle meningeal artery (MMA) passing through the sphenoidal crest was kept intact.…”

Section: Methodsmentioning

confidence: 99%

Clinical and angiographic outcomes after combined direct and indirect bypass in adult patients with moyamoya disease: A retrospective study of 76 procedures

et al. 2018

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Abstract. The present retrospective study was performed to evaluate the clinical outcome, as well as post-operative collateral formation and revascularization patterns in combined bypass. Surgical revascularization has been the mainstay of treatment for moyamoya patients. A total of 76 hemispheres from 64 moyamoya patients undergoing combined superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis and encephalo-duro-myo-synangiosis (EDMS) were retrospectively reviewed. Computed tomography perfusion and DSA were routinely performed. Modified Rankin scale (mRS) scoring and Kaplan-Meier analysis were performed, and post-operative collateral grading on digital subtraction angiography (DSA), reconstruction patterns and vessel diameter were measured to evaluate the revascularization area and vascular compensatory effect. During the follow-up period, the chief complaint was partially alleviated in 57/64 patients (89.1%). In all patients, mRS was significantly decreased after the operation. Good revascularization was established in most patients at 6 months after the surgery: 92.1% of sides were scored as 2 and 77.6% were scored as 3 by post-operative collateral grading on DSA. Dominant collateral revascularization originating from EDMS was more frequent than that from STA-MCA anastomosis (31 vs. 19 hemispheres) at 6-month follow-up. Morphologically, the calibers of the STA main trunk (2.60±0.65 mm) increased profoundly at the first 10 post-operative days (3.32±1.05 mm) and shrank back to pre-operative status at 6 months (2.20±1.01 mm) and 12 months (2.36±0.73 mm) according to DSA examination. Middle meningeal artery (MMA) and deep temporal artery (DTA) demonstrated continuous augmentation during the follow-up time (from 1.30±0.46 to 1.87±0.69 mm for MMA and 1.11±0.25 to 2.11±1.16 mm for DTA). These results strongly suggested that combined STA-MCA bypass and EDMS provided efficient revascularization and reduced acute cerebral events. The direct STA-MCA bypass provided early augmentation of cerebral perfusion, whereas the indirect EDMS provided a more durable long-term revascularization, indicating a complementary association between the two revascularization methods.

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Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy

Abstract: A procedure for preventing muscle atrophy in pterional craniotomy by temporalis muscle dissection is described, along with anatomical considerations. The inferior to superior dissection of the temporalis muscle is a very simple technique and is less invasive than other approaches.

Cited by 139 publications

References 6 publications

Myotendinous rupture of temporalis muscle: A rare injury following seizure

Myotendinous rupture of temporalis muscle: A rare injury following seizure

The “Agnes Fast” Craniotomy: The Modified Pterional (Osteoplastic) Craniotomy

Clinical and angiographic outcomes after combined direct and indirect bypass in adult patients with moyamoya disease: A retrospective study of 76 procedures

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