The anatomical basis for surgical preservation of temporal muscle

Kadri, Paulo A S; Al‐Mefty, Ossama

doi:10.3171/jns.2004.100.3.0517

Cited by 122 publications

(78 citation statements)

References 15 publications

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“…5 The need for a simple, fast, and easy way to perform a pterional craniotomy while preserving the temporalis muscle entirely with its bony attachment is the result of these considerations.…”

Section: Discussionmentioning

confidence: 99%

“…4 The morbidity of the pterional craniotomy includes fascial nerve palsies, temporomandibular joint pain, and temporal muscle atrophy. 5 Trying *Aganetha ''Agnes Fast'' Anderson (1883-1977) was a nurse known as ''Florence Nightingale of Steinbach'' and was born in 1883 in Canada. Agnes became a local hero in 1918 when she helped fight the Spanish flu epidemic in Steinbach.…”

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confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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

et al. 2011

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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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“…Temporal hollowing can be a disfiguring complication after a craniotomy or craniectomy operation, and is associated with poor temporalis muscle function and temporomandibular joint pain [1][2][3]. This cosmetic and functional disfigurement involving the temporalis muscle is exacerbated after hemi-craniectomy, commonly utilized in patients with traumatic brain injury or large ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%