Conservative treatment of severe limited mouth opening after transtemporal craniotomy

Limited mouth opening (LMO) is a common complication of the transtemporal craniotomy that is often involved in the temporalis and temporomandibular joint. The occurrence of prolonged LMO was rare. Risk factors for such limitation after these neurosurgical procedures are defined, and the strategies of treatment and prevention are further discussed.This article presents 12 patients with severe LMO after transtemporal neurosurgical procedures. Four patients received myofunctional training combined with the neuromuscular blocking in the temporalis, which methods may be more effective for LMO within 3 months. Five patients received myofunctional training combined with joint injection of hyaluronic acid, which methods may be more effective for LMO beyond 3 months. In addition, 2 patients who experienced LMO for more than 1 year had to receive coronoidectomy.Therefore, these conservative treatments have proved a useful method to restore LMO at an early stage. If intervention and diagnosis was delayed, the efficiency of these conservative therapies would decline, and coronoidectomy has to be considered. The early physiotherapy cannot be overemphasized to minimize this complication after these transtemporal neurosurgical procedures.