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Updated: Jun 5, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

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Osteoplastic pterional craniotomy revisited.

Ealmaan Kim1, Johnny B Delashaw

  • 1Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.

Neurosurgery
|January 6, 2011
PubMed
Summary
This summary is machine-generated.

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This modified pterional craniotomy preserves temporalis muscle and bone, enhancing cosmetic outcomes for brain aneurysm surgery. The technique resulted in minimal muscle atrophy and excellent bone flap fusion in patients.

Area of Science:

  • Neurosurgery
  • Surgical Techniques
  • Cranial Surgery

Background:

  • The standard pterional approach for brain aneurysm treatment, popularized by Yaşargil, utilizes a free bone flap.
  • This technique is widely adopted but can sometimes lead to aesthetic concerns.

Purpose of the Study:

  • To present a modified pterional craniotomy technique designed to improve cosmetic results.
  • The modification aims to mobilize the sphenoid wing and pterion en bloc with the temporalis muscle.

Main Methods:

  • A subperiosteal dissection facilitates retrograde separation of the temporalis muscle.
  • Inferior chisel cuts into the sphenoid wing allow en bloc removal of the pterion and sphenoid wing with the bone flap.
  • The technique was applied to 40 patients undergoing aneurysm surgery, with cosmetic outcomes assessed at 6 months.

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Last Updated: Jun 5, 2026

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Published on: August 11, 2015

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Main Results:

  • A significant majority of patients (92.5%) showed minimal temporalis muscle atrophy.
  • Three-dimensional computed tomography scans confirmed excellent configuration and fusion of the pterional bone flap.
  • The modified approach yielded favorable cosmetic outcomes.

Conclusions:

  • This muscle-preserving and bone-sparing pterional approach offers improved cosmesis with minimal additional surgical effort.
  • The technique effectively maintains temporalis muscle function.
  • Enhanced aesthetic results are achievable in pterional craniotomy for aneurysm treatment.