title: A Simple Method for Reconstruction of the Temporalis Muscle Using Contourable Strut Plate after Pterional Craniotomy: Introduction of the Surgical Techniques and Analysis of Its Efficacy.
abstract: OBJECTIVE
  Pterional craniotomy (PC) using myocutaneous (MC) flap is a simple and efficient technique; however, due to subsequent inferior displacement (ID) of the temporalis muscle, it can cause postoperative deformities of the muscle such as depression along the inferior margin of the temporal line of the frontal bone (DTL) and muscular protrusion at the inferior portion of the temporal fossa (PITF). Herein, we introduce a simple method for reconstruction of the temporalis muscle using a contourable strut plate (CSP) and evaluate its efficacy.
  
  
  METHODS
  Patients at follow-ups between January 2014 and October 2014 after PCs were enrolled in this study. Their postoperative deformities of the temporalis muscle including ID, DTL, and PITF were evaluated. These PC cases using MC flap were classified according to two groups; one with conventional technique without CSP (MC Only) and another with reconstruction of the temporalis muscle using CSP (MC + CSP). Statistical analyses were performed for comparison between the two groups.
  
  
  RESULTS
  Lower incidences of ID of the muscle (p < 0.001), DTL (p < 0.001), and PITF (p = 0.001) were observed in the MC + CSP than in the MC Only group. The incidence of acceptable outcome was markedly higher in the MC + CSP group (p < 0.001). ID was regarded as a causative factor for DTL and PITF (p < 0.001 in both).
  
  
  CONCLUSIONS
  Reconstruction of the temporalis muscle using CSP after MC flap is a simple and efficient technique, which provides an outstanding outcome in terms of anatomical restoration of the temporalis muscle.
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Jin-Hack
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Yoon-Soo
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Sang-Jun
authors.initials: SJ
authors.lastname: Suh
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Jeong-Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Kee-Young
authors.initials: KY
authors.lastname: Ryu
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Dong-Gee
authors.initials: DG
authors.lastname: Kang
keywords: Contourable strut plate; Deformities; Myocutaneous flap; Pterional; Temporal line; Temporalis