Azab Mohammed A, Sarhan Khalid, Atallah Oday, Hernández-Hernández Alan, Ibrahim Ismail A, Shama Mohsen Nabih, Hazim Ahmed, Kammoun Brahim
Faculty of Medicine, Department of Neurosurgery, Cairo University Hospital, Cairo, Egypt.
Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Ann Med Surg (Lond). 2025 May 26;87(7):4442-4451. doi: 10.1097/MS9.0000000000003385. eCollection 2025 Jul.
The temporalis muscle is commonly dissected and mobilized during craniotomy. Cosmetic and functional complications may arise from the improper handling of this muscle. Surgery for recurrent pathologies may be challenging due to adhesions and muscle damage.
A systematic review following PRISMA guidelines was conducted to consolidate literature on the potential techniques used for preserving the temporalis muscle during neurosurgical interventions. PubMed, Scopus, and Web of Science were systematically searched using predefined criteria from inception to 2025. A qualitative synthesis was done summarizing the primary cranial pathology, type of surgical approach, the technical clue for temporalis muscle preservation, follow up and complications.
We included 27 eligible articles with a total number of 811 patients. About 508 (62.6%) of patients underwent pterional approach, while 150 (18.4%) patients had decompressive craniotomies. Aneurysm clipping was the surgical indication in 172 (21.2%) patients, while decompressive surgery was done for traumatic brain injuries in about 48 (5.9%) patients. Osteoplastic temporalis muscle flap was used in 178 (21.9%) patients, while some authors sutured the temporalis muscle to the cranioplasty plate in 79 (9.7%) patients. Fixation of the temporalis muscle to the bone using sutures through small holes was done in 100 (12.33%) patients. No chewing problems were recorded among all the patients analyzed. Temporalis muscle atrophy was observed in only 13 (1.6%) patients.
Proper manipulation of the temporalis muscle during surgery is crucial for the vitality of its fibers and to prevent postoperative functional or cosmetic drawbacks.
开颅手术期间通常会对颞肌进行解剖和游离。对该肌肉处理不当可能会导致美容和功能方面的并发症。由于粘连和肌肉损伤，复发性病变的手术可能具有挑战性。
按照PRISMA指南进行系统评价，以整合有关神经外科手术中用于保留颞肌的潜在技术的文献。从创刊至2025年，使用预定义标准对PubMed、Scopus和科学网进行系统检索。进行定性综合分析，总结主要的颅骨病变、手术入路类型、保留颞肌的技术要点、随访情况及并发症。
我们纳入了27篇符合条件的文章，共811例患者。约508例（62.6%）患者接受了翼点入路，而150例（18.4%）患者进行了减压性开颅手术。172例（21.2%）患者的手术指征为动脉瘤夹闭，约48例（5.9%）患者因创伤性脑损伤进行了减压手术。178例（21.9%）患者使用了骨成形颞肌瓣，而79例（9.7%）患者的一些作者将颞肌缝合至颅骨成形板。100例（12.33%）患者通过小孔用缝线将颞肌固定于骨。在所有分析的患者中均未记录到咀嚼问题。仅13例（1.6%）患者观察到颞肌萎缩。
手术期间对颞肌进行恰当操作对于其纤维的活力以及预防术后功能或美容缺陷至关重要。
