Less invasive reconstruction of the temporalis muscle for pterional craniotomy: modified procedures.
BACKGROUND
I developed a modified pterional craniotomy technique which is less invasive for both the facial nerve and the temporalis muscle.


METHODS
The keys to this procedure are subfascial dissection and reflection of the temporalis fascia without interfascial dissection, and posterior displacement of the temporalis muscle without muscular incision. The limited exposure from the bulky temporalis muscle can be avoided with this procedure. A small cuff of the fascia-periostium complex is left on a free bone flap along the superior temporal line to facilitate the subsequent muscle closure.


RESULTS
Since the facial nerve and temporalis muscle are not injured with this procedure, the functional and cosmetic results are satisfactory.


CONCLUSIONS
To reduce functional and cosmetic complications, and the cost of pterional craniotomy, I believe that my procedure is recommended.
Miyazawa
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Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
D003399:Craniotomy / Q000379:methods*; D006801:Humans; D011187:Posture; D019651:Plastic Surgery Procedures / Q000379:methods*; D013703:Temporal Muscle / Q000601:surgery*