• Francisco Manuel Grajeda-García and Fanny Mercado-Caloca.
• Departamento de Neurocirugía, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México. francisco_graj@yahoo.com.mx
• Rev Med Inst Mex Seguro Soc. 2011 Nov 1;49(6):649-54.

Backgroundthe cosmetic deformities that appear after a pterional craniotomy are usually the result of atrophy of the temporal muscle, lesion of the frontotemporal branch of the facial nerve or occur as a consequence of the way the craniotomy was done.The objective was to compare the functional and aesthetic complications from both the classic pterional approach and the osteomyoplastic flap type approach in patients with supratentorial surgical pathology either vascular or tumoral.Methodsa retrospective observational comparative survey was done. All the patients operated on who required a pterional approach for a supratentorial pathology and were given either a classic pterional approach or an osteomyoplastic pterional flap were included.Resultsthe variables: surgical time and hollowing had significant differences; the pterional approach with less operative time (p < 0.001) and the osteomyoplastic approach with less hollowing perceived by the patients (p = 0.013).Conclusionsthe osteomyoplastic flap showed a less severe hollowing in the temple although it demands more time in order to perform it. The frequency of complications seems to be the same.

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