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Temporal Dissection Technique That Prevents Temporal Hollowing in Coronal Approach

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Authors
Baek, Rong-Min; Heo, Chan Yeong; Lee, Sang Woo
Issue Date
2009-05
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
JOURNAL OF CRANIOFACIAL SURGERY; Vol.20 3; 748-751
Keywords
Coronal approachtemporal hollowingtemporal dissection
Abstract
Temporal hollowing after lateral facial skeletal exposure via a coronal approach is not uncommon. This is caused by injury to the superficial temporal fat pad. However, to prevent facial nerve injury at the zygomatic arch, incision of the superficial layer of the temporalis fascia (TF) and exposure of the temporal fat pad are accompanied with most coronal approaches. Here we introduce our method of dissection of the suprasuperficial layer of the TF without exposure of the temporal fat pad and report on its safety and efficacy. Temporal dissection just superficial to the superficial layer of the TF was performed to the superior border of the zygomatic arch. After identifying the zygomatic arch, an incision was made at the posterosuperior aspect of the arch, when exposure of the arch was necessary for access to the lateral skeleton. From 1989 to 2008, 522 patients undergoing craniofacial surgery via coronal approach were analyzed retrospectively. No patient developed temporal hollowing. However, 14 patients (2.7%) developed frontal weakness immediately postoperatively, and 2 of them had permanent paresis. The frequency of this motor morbidity was low compared with that of other reports. Preservation of the temporal fat pad in coronal approach is essential for the prevention of temporal hollowing, and for this, we recommend suprasuperficial layer of TF dissection.
ISSN
1049-2275
Language
English
URI
http://hdl.handle.net/10371/78254
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College of Medicine/School of Medicine (의과대학/대학원)Plastic Surgery (성형외과학전공)Journal Papers (저널논문_성형외과학전공)
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