How to Prevent a Limitation of Mouth Opening Following Fronto-temporal Craniotomy

Although a number of operative procedures have been already reported to prevent cosmetic and functional complications following fronto-temporal craniotomy, little has been analyzed concerning the limitation of mouth opening due to the atrophy, fibrosis and contracture of the temporal muscle. Our focus was placed on the changes and degrees of maximum postoperative mouth opening day by day following fronto-temporal craniotomy. We evaluated the efficacy of newly modified craniotomy (n=17) compared with the previous conventional one (n=14). Our modified surgical strategy comprises: 1) tailored fascia and pericranium in Z-shaped fashion, 2) gentle manipulation of fascia, pericranium and muscle, and 3) ample humidification of fascia, pericranium and muscle wrapped with soaked saline gauze during operation. In this maneuver, the temporal muscle was firmly anchored to the fascia and pericranium in the original position. Postoperative limited mouth opening of the modified group was quickly (P<0.05) and fully resolved with statistical significance.