Subperiosteal subtemporal approach: technique and applications

The authors describe a craniofacial surgical approach that they have used since 1987. Based on existing anatomical continuity between the subtemporal plane and the cranial periosteum, it consists of a direct subperiosteal subtemporal cleavage. Preservation of continuity between the muscle and the periosteum allows the operator to return the temporalis muscle to a normal position at the end of the operation when the scalp is sutured. This approach avoids superficial cleaving of the temporalis muscle or section and reinsertion to the fronto-orbital rim. It also allows access to the upper third of the face without jeopardizing the frontal ramus of the facial nerve.