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Related Experiment Videos

Current methods for brow fixation: are they safe?

Jennifer L Walden1, Michael J Orseck, Sherrell J Aston

  • 1Manhattan Eye, Ear and Throat Hospital, 50 East 71st Street, New York, NY 10021, USA. drjenniferwalden@hotmail.com

Aesthetic Plastic Surgery
|September 16, 2006
PubMed
Summary
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Skull thickness varies, with posterior and medial sites being thickest. Female skulls were thicker than male skulls, and fixation techniques like cortical tunnels and Mitek screws showed no inner table penetration, reducing risks in brow-lift surgery.

Area of Science:

  • Anatomy
  • Neurosurgery
  • Plastic Surgery

Background:

  • Forehead-lift fixation techniques lack universal acceptance.
  • Current methods carry risks like alopecia, implant issues, and dural injury.

Purpose of the Study:

  • To anatomically evaluate calvarial thickness at key brow fixation points.
  • To compare the cranial penetration depth of various fixation techniques.

Main Methods:

  • Calvarial thickness was measured in 14 cadavers at specific points (A-F).
  • Fixation techniques including cortical tunnels, screws (2.0-mm, Mitek, Endotine), and miniscrews were simulated.
  • Penetration depth and inner table breach potential were assessed.

Main Results:

Related Experiment Videos

  • Posterior and medial calvarial sites (C-F) were thickest.
  • Female skulls were significantly thicker than male skulls.
  • Cortical tunnels and Mitek screws did not penetrate the inner table; one Endotine device and three miniscrews did.

    • Conclusions:

    • Calvarial thickness varies by anatomical site and gender, with posterior/medial sites and female skulls being thicker.
    • Certain fixation techniques, like cortical tunnels and Mitek screws, appear safer regarding inner table penetration.
    • Surgeons must consider calvarial anatomy to minimize risks like cerebrospinal fluid leak during brow fixation.