Combined subgaleal/myocutaneous technique for temporalis muscle dissection

A. Samy Youssef, Amir Ahmadian, Edwin Ramos, Fernando Vale Diaz, Harry R. Van Loveren

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The frontal branch of the facial nerve (FBFN) is the most susceptible neural structure to injury during frontotemporal craniotomies. The balance between adequate temporalis muscle mobilization and frontal branch protection with minimal anatomical alteration is the philosophy behind our approach to temporalis muscle dissection. Objective: To describe a combined subgaleal/myocutaneous technique for dissection and mobilization of the temporalis muscle in anterolateral cranial approaches. Methods: Interdisciplinary literature review of the anatomical course of the FBFN was performed. Retrospective analysis of anterolateral craniotomies performed at our institution in which the combined subgaleal/myocutaneous (CSGMC) technique was performed. Results: A total of 71 cases of anterolateral craniotomies (excluding full variant orbitozygomatic) were performed with the successful application of a CSGMC technique (36 pterional, 31 orbitopterional, and 4 fronto-orbital). Partial frontalis weakness was transient in one case. Conclusion: The CSGMC technique provides suf ficient protection for the FBFN and allows for adequate mobilization for a variety of skull base exposures while minimally violating myofascial anatomy. This is the fi rst reported technique that allows both adequate temporalis muscle mobilization with performance of the one-piece orbito-frontal and orbitopterional approaches, without disruption of the super ficial/deep temporalis fascia and fat-pad complex.

Original languageEnglish (US)
Pages (from-to)387-393
Number of pages7
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume73
Issue number6
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

Fingerprint

Dissection
Craniotomy
Facial Nerve
Muscles
Fascia
Skull Base
Adipose Tissue
Anatomy
Wounds and Injuries

Keywords

  • Facial nerve
  • Frontalis palsy
  • Interfascial
  • Subfascial
  • Temporalis

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Combined subgaleal/myocutaneous technique for temporalis muscle dissection. / Youssef, A. Samy; Ahmadian, Amir; Ramos, Edwin; Vale Diaz, Fernando; Van Loveren, Harry R.

In: Journal of Neurological Surgery, Part B: Skull Base, Vol. 73, No. 6, 01.01.2012, p. 387-393.

Research output: Contribution to journalArticle

Youssef, A. Samy ; Ahmadian, Amir ; Ramos, Edwin ; Vale Diaz, Fernando ; Van Loveren, Harry R. / Combined subgaleal/myocutaneous technique for temporalis muscle dissection. In: Journal of Neurological Surgery, Part B: Skull Base. 2012 ; Vol. 73, No. 6. pp. 387-393.
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