Splitting of temporalis muscle for basal exposure--technical note

Splitting of the temporalis muscle to increase the basal exposure in subtemporal approaches is discussed. The temporalis muscle is split vertically in the direction of its insertion at the coronoid process of the mandible up to the zygomatic arch and the split components of the muscle are retracted apart. This simple procedure significantly reduces the obstruction caused by the temporalis muscle during subtemporal surgery. The procedure was employed in six patients with tumors located in the basal temporal, posterior cavernous sinus, and petrous apex region. Zygomatic osteotomy could be avoided in selected patients and the exposure of the infratemporal fossa region could be widened by employing this technique. The function and bulk of the temporalis muscle were effectively preserved.