title: Aesthetic issues in neurosurgery: a protocol to improve cosmetic outcome in cranial surgery.
abstract: Nowadays, surgical interventions must treat with care the aesthetic impact on the patient, even when a malignant pathology or an patient's advanced age could give the aesthetic issue lower priority. The cranio-facial area is probably the most important anatomical region with regard to the harmony of the human body. Consequently, a step-by-step procedure, applicable regardless of the site and the nature of the lesion, is advisable to minimize the aesthetic impact. We prospectively analyzed 65 patients during a period of 2 years. At 1-year follow-up, all patients were invited to undergo a 3D-multislice CT and to complete a questionnaire with a subjective rating scale about aesthetic impact. The 3D-multislice CT scan didn't show dislocations, depressions or gaps of the bone flap. Nevertheless, five patients complained of some degree of aesthetic injury, or reported a psychological suffering from the aesthetic consequences of surgery. As a control group, we retrospectively reviewed 223 patients. The authors describe their surgical protocol and discuss it in the light of the results of their series.
authors.affiliation: Department of Neurosurgery IRCCS-Neuromed, Pozzilli, IS, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Frati
authors.forename: Angelo
authors.initials: A
authors.lastname: Pichierri
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Esposito
authors.forename: Riccardo
authors.initials: R
authors.lastname: Frati
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Cantore
authors.forename: Stefano
authors.initials: S
authors.lastname: Bastianello
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000505:Alopecia / Q000209:etiology; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control*; D003399:Craniotomy; D005152:Facial Muscles / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006204:Hair Removal; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control*; D011446:Prospective Studies; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery; D013699:Temporal Arteries / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome