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Post-Neurosurgical Temporal Deformities: Various Techniques for Correction and Associated Complications
Gabriel F Santiago1,2, Jordan Terner3, Amir Wolff1,2
1Neuroplastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore.
The Journal of Craniofacial Surgery
|June 5, 2018
Summary
Temporal hollowing deformity (THD) correction is challenging. Alloplastic materials are safer than fat or dermal fillers for severe THD reconstruction, avoiding catastrophic complications.
Area of Science:
- Plastic Surgery
- Neurosurgery
- Craniofacial Reconstruction
Background:
- Temporal hollowing deformity (THD) affects up to 50% of patients post-neurosurgical pterional dissection.
- Surgical correction of THD presents significant challenges with high failure and morbidity rates.
Purpose of the Study:
- To review anatomical factors contributing to postsurgical temporal deformity.
- To present prevention and surgical correction techniques for THD.
- To analyze complication profiles of various THD correction methods.
Main Methods:
- Anatomical review of temporal fossa.
- Description of surgical techniques for THD prevention and correction.
- Systematic review of 25 articles on THD correction outcomes and complications.
Main Results:
- Complications include infection, malposition, revision, pain, and implant removal.
- Autologous fat and dermal filler augmentation show high complication rates, including stroke and death.
- Alloplastic materials, autologous bone, and free tissue transfer reported no catastrophic complications.
Conclusions:
- Injection augmentation with fat or dermal filler is linked to catastrophic complications.
- Alloplastic materials demonstrated no associated catastrophic complications.
- Alloplastic reconstruction is preferred for severe THD cases.
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