Postcraniotomy function of the temporal muscle in skull base surgery: technical note based on a preliminary study.

Area of Science:

• Neurosurgery
• Oral and Maxillofacial Surgery
• Anatomy

Background:

• Craniotomies often require temporal muscle (TM) preparation, potentially leading to temporomandibular joint (TMJ) dysfunction.
• Postoperative TMJ impairment following craniotomies is an under-discussed clinical issue.

Purpose of the Study:

• To develop and validate a questionnaire to assess TMJ dysfunction after craniotomy.
• To evaluate the correlation between different TM preparation techniques and postoperative TMJ dysfunction.

Main Methods:

• A prospective study involving 286 patients undergoing pterional or temporal craniotomies between 2004-2006.
• Intraoperative TM preparation techniques included interfascial, submuscular, or subfascial methods.
• A validated patient-based questionnaire assessed postoperative TMJ functional outcomes in 69 eligible patients.

Main Results:

• 17% of patients reported TMJ pain or restricted mouth opening between 3-12 months post-surgery.
• Most complaints (92%) occurred within 3 months, with pain easing in 58% of affected patients.
• Subfascial TM preparation was associated with fewer postoperative complaints compared to other techniques.

Conclusions:

• The developed questionnaire is a suitable tool for postoperative quality control of TMJ function.
• Subfascial preparation of the temporal muscle is recommended to minimize postoperative TMJ dysfunction.