The Usefulness of the Frontolateral Approach as a Minimally Invasive Corridor for Clipping of Anterior Circulation Aneurysm

OBJECTIVE: Several studies have reported on the effectiveness of fronto-lateral craniotomy in reducing the operating time and post-operative complications. However, no study has practically evaluated this method from the cosmetic point of view. MATERIALS AND METHODS: We designed this study for comparison of the clinical differences and cosmetic outcomes between the frontolateral craniotomy and the conventional pterional craniotomy for clipping of unruptured intracranial aneurysms. We performed a retrospective analysis of the two groups based on their medical records and radiologic findings juxtaposed with their length of hospital stay, intensive care unit day and operation time, and the emergence of postoperative complication, mean size of aneurysm, and temporal depression. RESULTS: After careful comparison of the thickness of temporalis muscle between the craniotomy side and the contralateral side, the results clearly showed that the conventional pterional craniotomy group was asymmetric by a p value of 0.152 and the frontolateral craniotomy group was symmetric by a p value of 0.002. CONCLUSION: Frontolateral craniotomy could be a practical alternative for patients with an unruptured intracranial aneurysm in the anterior circulation including the posterior communicating artery, particularly those who are in a medically poor state or who highly demand minimal aesthetic mutilation.

Reconstruction of anterior temporal depression after the coronal approach

Application of superficial temporal fascia flap in reconstruction of temporal depression / 中华医学美学美容杂志

Objective To evaluate the effect of superficial temporal fascia flap for the reconstruction of temporal depression. Methods According to the degree of temporal depression, we applied folded superficial temporal fascia to reconstruct the temporal depression, combined with forehead and orbital subperiosteal facelift. Results Postoperative follow-up for 1~2 years showed that the method used in subperiosteal facelift combined with temporal depression, maintained a satisfactory long-term full contour. And it improved the facial contour.Conclusions Application of superficial temporal fascia flap in reconstructing the temporal depression combined with facelift for one-stage is a good method. It can get the purposes of tightening the skin and improving the facial contour together. Good results are achieved.