scholarly journals Interdigitated craniotomy: a simple technique to fix a bone flap with only a single plate

2015 ◽  
Vol 123 (4) ◽  
pp. 1055-1058 ◽  
Author(s):  
Noboru Takahashi ◽  
Kazunori Fujiwara ◽  
Keiichi Saito ◽  
Teiji Tominaga
Keyword(s):  
Simple Technique ◽  
Plate Fixation ◽  
Bone Flap ◽  
Cranial Bone ◽  
Temporalis Muscle ◽  
Cosmetic Results ◽  
Pterional Craniotomy ◽  
Single Plate ◽  
Radiological Images ◽  
Cut Surface

In pterional craniotomy, fixation plates cause artifacts on postoperative radiological images; furthermore, they often disfigure the scalp in hairless areas. The authors describe a simple technique to fix a cranial bone flap with only a single plate underneath the temporalis muscle in an area with hair, rather than using a plate in a hairless area. The key to this technique is to cut the anterior site of the bone flap at alternate angles on the cut surface. Interdigitation between the bone flap and skull enables single-plate fixation in the area with hair, which reduces artifacts on postoperative radiological images and provides excellent postoperative cosmetic results.

Osteoplastic Pterional Craniotomy Revisited

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons125-ons129 ◽  
Author(s):  
Ealmaan Kim ◽  
Johnny B. Delashaw
Keyword(s):  
Computed Tomography ◽  
Muscle Function ◽  
Bone Flap ◽  
Temporalis Muscle ◽  
Pterional Approach ◽  
3 Dimensional ◽  
Pterional Craniotomy ◽  
Computed Tomography Scans ◽  
Brain Aneurysms ◽  
Additional Labor

Abstract BACKGROUND: A standard pterional approach with a free bone flap to treat brain aneurysms was first introduced and popularized by Yaşargil. 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.

Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy

1996 ◽  
Vol 84 (2) ◽  
pp. 297-299 ◽  
Author(s):  
Susumu Oikawa ◽  
Masahiko Mizuno ◽  
Shinsuke Muraoka ◽  
Shigeaki Kobayashi
Keyword(s):  
Muscle Atrophy ◽  
Simple Technique ◽  
Temporalis Muscle ◽  
Content Type ◽  
Pterional Craniotomy ◽  
Less Invasive ◽  
Fine Print

✓ A procedure for preventing muscle atrophy in pterional craniotomy by temporalis muscle dissection is described, along with anatomical considerations. The inferior to superior dissection of the temporalis muscle is a very simple technique and is less invasive than other approaches.

Bridged craniotomy for stable fixation of a bone flap

1996 ◽  
Vol 85 (3) ◽  
pp. 518-519 ◽  
Author(s):  
Chikayuki Ochiai ◽  
Soshi Okuhata ◽  
Yuhei Yoshimoto ◽  
Masakatsu Nagai
Keyword(s):  
Simple Technique ◽  
Operating Time ◽  
Bone Flap ◽  
Stable Fixation ◽  
Content Type ◽  
Cosmetic Results ◽  
Additional Operating Time ◽  
Fine Print

✓ Postoperative depression of the bone flap is a common and bothersome problem in craniotomies. In this paper, a simple technique to avoid this deformity is described. The key to this technique is to leave uncut a part of each osteotomy approximately 5 mm in width as a “bridge” to the bone flap, which is then subsequently cut with the aid of a chisel. This technique provides stable fixation of the bone flap and satisfactory cosmetic results with little additional operating time.

Reconstruction of the temporalis muscle for the pterional craniotomy

1990 ◽  
Vol 73 (4) ◽  
pp. 636-637 ◽  
Author(s):  
Robert F. Spetzler ◽  
K. Stuart Lee
Keyword(s):  
Bone Flap ◽  
Temporalis Muscle ◽  
Content Type ◽  
Pterional Craniotomy ◽  
Fine Print

✓ Several techniques have been employed to incise the temporalis muscle for the pterional craniotomy. The authors describe a method which provides the advantage of a free bone flap, yet allows anatomical reapproximation of the temporalis muscle to its bone attachment.

P100 Removing the orbital bar in fronto-orbital advancement and reconstruction

2019 ◽  
Vol 90 (3) ◽  
pp. e48.3-e49
Author(s):  
A Sheikh ◽  
M Schramm ◽  
P Carter ◽  
J Russell ◽  
M Liddington ◽  
...  
Keyword(s):  
Bone Graft ◽  
Retrospective Analysis ◽  
Frontal Bone ◽  
Cosmetic Results ◽  
Absorbable Sutures ◽  
Radiological Images ◽  
Coronal Synostosis ◽  
Excellent Source

ObjectivesTo describe our technique of using reverse frontal bone graft for FOAR for patients with metopic or coronal synostosis.DesignRetrospective analysis of digital records for operation notes and radiological images.SubjectsSince April 2014, 16 patients underwent FOAR without using orbital bar.MethodsWe plan a frontal bone graft using Marchac template and increase the angles on side by 1 cm. This graft is then reversed and supra orbital margins are drilled out. The orbital bar is then removed and drilled down to make bone dust which is then used to fill gaps on exposed dura. The reversed frontal graft is then placed in front and secured via absorbable sutures, plate and screws.ResultsAll 16 patients who underwent this technique have shown excellent cosmetic results with no complications or non healing. Removing orbital bar does not cause any cosmetic defect since orbital rims are drilled out in reverse frontal bone graft. The removed orbital bar provides an excellent source of bone dust to cover gaps on exposed dura.ConclusionsWe present our technique of FOAR without using orbital bar, which is drilled down to bone dust to fill gaps. This has shown excellent cosmetic results so far with no complications. This addresses the issue of temporal thinning.

Temporalis muscle fixation in pterional craniotomy. Technical note

Neurocirugía ◽  
1998 ◽  
Vol 9 (1) ◽  
pp. 74-78 ◽  
Author(s):  
V. Vanaclocha
Keyword(s):  
Technical Note ◽  
Temporalis Muscle ◽  
Pterional Craniotomy

scholarly journals 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

2015 ◽  
Vol 17 (2) ◽  
pp. 93 ◽  
Author(s):  
Jin-Hack Park ◽  
Yoon-Soo Lee ◽  
Sang-Jun Suh ◽  
Jeong-Ho Lee ◽  
Kee-Young Ryu ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Temporalis Muscle ◽  
Simple Method ◽  
Pterional Craniotomy

Potential utility of bone scan in cranial bone flap osteomyelitis

2019 ◽  
Vol 33 (6) ◽  
pp. 424-433
Author(s):  
Alexandre Bani Sadr ◽  
Bastien Gregoire ◽  
Jeremie Tordo ◽  
Jacques Guyotat ◽  
Andre Boibieux ◽  
...  
Keyword(s):  
Bone Scan ◽  
Bone Flap ◽  
Cranial Bone ◽  
Potential Utility

scholarly journals Craniotomy Revisited: Techniques for Improved Access and Reconstruction

2000 ◽  
Vol 27 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Michael D. Cusimano ◽  
Agustinus S. Suhardja
Keyword(s):  
Soft Tissue ◽  
Operating Time ◽  
Additional Cost ◽  
Bone Flap ◽  
Temporalis Muscle ◽  
Native Bone ◽  
Soft Tissue Dissection ◽  
Tissue Dissection ◽  
Orbital Rim ◽  
Additional Operating Time

ABSTRACT:Objective:To describe simple modifications of the technique of opening and closure of the craniotomy to improve basal exposure and reconstruction.Methods:The modifications involve: a) additional soft-tissue dissection which is carried downward to the base of the ear and to the orbital rim, exposing the orbital rim and malar eminence without removing the bone; b) cutting the bone flap so that ‘bridges’ of bone remain that help to stabilize the flap when it is returned to the cranium at the end of the operation; c) the wedging of bone chips between the bone flap and native cranium at the time the bone is being reaffixed so as to provide firm stability by diminishing movement of the bone flap; d) the use of bone dust and bone chips mixed with the patient's blood to seal and bridge the gap between the bone flap and the native bone; e) reattachment of the temporalis muscle with the bone flap sutures. An ‘inlay’ technique of duraplasty is also described.Results and Conclusion:These simple modifications of craniotomy provide better basal exposure and reconstruction with little additional operating time at no additional cost.

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