Osteoplastic pterional craniotomy revisited
- Affiliated Author(s)
- 김엘
- Alternative Author(s)
- Kim, El
- Journal Title
- Operative Neurosurgery
- ISSN
- 2332-4252
- Issued Date
- 2011
- Keyword
- Aneurysm; Cosmetic result; Craniotomy; Pterional approach; Surgical technique
- Abstract
- BACKGROUND: A standard pterional approach with a free bone flap to treat brain
aneurysms was first introduced and popularized by Yasxargil.
OBJECTIVE: To describe a modified pterional craniotomy technique and that mobilizes
part of the sphenoid wing and the pterion in a block with the temporalis muscle to
enhance cosmetic results.
METHODS: A subperiosteal corridor is provided inferiorly by separating the temporalis
muscle from the underlying bone in a retrograde dissection. Inferior chisel cuts from the
front and back enter the sphenoid wing, enabling removal of part of the sphenoid wing
and the pterion in 1 piece, along with the bone flap. Forty patients with aneurysms were
treated in this fashion, and the cosmetic outcome was examined at 6 months postoperatively.
RESULTS: Thirty-seven patients (92.5%) demonstrated an unremarkable degree of
temporalis muscle atrophy. Excellent configuration and fusion of the pterional bone flap
were observed on 3-dimensional computed tomography scans.
CONCLUSION: With the use of this muscle-preserving and bone-sparing pterional
approach and with little additional labor, temporalis muscle function is preserved and
improved cosmesis is obtained.
KEY WORDS: Aneurysm, Cosmetic result, Craniotomy, Pterional approach, Surgical technique
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