Abstract
Background: The pterional approach for craniotomy, one of the most used surgical intervention in neurosurgery, results in a series of postoperative changes that, if they persist, affect the patient’s life, social reintegration, and his/her physical and mental recovery. The aim of the present study was to develop and validate a questionnaire for indicating directly affected masticatory muscles groups and facial nerve branches, in patients undergoing the pterional approach in neurosurgery, so that the recovery therapy can be monitored and personalized. Methods: A self-reporting questionnaire consisting of 18 items (12 for postoperative masticatory status and 6 for facial nerve branches involvement), validated on fifteen patients, following three steps: items development, scale development, and scale evaluation, was prospectively applied twice, at a one-year interval (T0 and T1), with thirty-two patients suffering from vascular or tumoral pathology and surgically treated through a pterional approach. Results: No statistically significant correlation could be found between postoperative outcomes and age or gender. Facial nerve branch involvement could not be correlated with any of the assessed variables. Pathology and time elapsed from surgery were statistically significantly correlated to preauricular pain on the non-operated side (p = 0.008 and p = 0.034, respectively). Time elapsed from surgery was statistically significantly correlated to the ability to chew hard food, pain while yawning, and preauricular pain during back and forward jaw movements and gradual mouth opening. Conclusions: We created and validated a valuable patient-centered questionnaire that can be employed as a tool for postoperative assessment of directly affected masticatory muscles and groups of facial nerve branches.
Highlights
The pterional approach for craniotomy is one of the most used surgical interventions in neurosurgery, being recommended for lesions arising along the anterior and middle skull base, such as vascular pathology, anterior and central skull base tumor resections, and in addressing certain frontal or frontal-temporal intra-axial tumors [1]
Since it was first described by Yasargil et al in 1976 [2], several improvements of the technique have been made to avoid adverse postoperative changes or complications, such as longer-lasting palsy of frontotemporal facial nerve branches, temporalis muscle atrophy, and temporomandibular joint (TMJ) dysfunction [1]
The pterional surgical intervention applied for brain tumors results in a series of postoperative changes that, if they persist, affect the patient’s life, social reintegration, and his/her physical and mental recovery
Summary
The pterional approach for craniotomy is one of the most used surgical interventions in neurosurgery, being recommended for lesions arising along the anterior and middle skull base, such as vascular pathology (aneurysms occurring in the anterior circulation, in the Circle of Willis, or in certain aneurysms in the posterior circulation), anterior and central skull base tumor resections, and in addressing certain frontal or frontal-temporal intra-axial tumors [1].Since it was first described by Yasargil et al in 1976 [2], several improvements of the technique have been made to avoid adverse postoperative changes or complications, such as longer-lasting palsy of frontotemporal facial nerve branches, temporalis muscle atrophy, and temporomandibular joint (TMJ) dysfunction [1].The pterional surgical intervention applied for brain tumors results in a series of postoperative changes that, if they persist, affect the patient’s life, social reintegration, and his/her physical and mental recovery. The pterional approach for craniotomy is one of the most used surgical interventions in neurosurgery, being recommended for lesions arising along the anterior and middle skull base, such as vascular pathology (aneurysms occurring in the anterior circulation, in the Circle of Willis, or in certain aneurysms in the posterior circulation), anterior and central skull base tumor resections, and in addressing certain frontal or frontal-temporal intra-axial tumors [1] Since it was first described by Yasargil et al in 1976 [2], several improvements of the technique have been made to avoid adverse postoperative changes or complications, such as longer-lasting palsy of frontotemporal facial nerve branches, temporalis muscle atrophy, and temporomandibular joint (TMJ) dysfunction [1]. Conclusions: We created and validated a valuable patient-centered questionnaire that can be employed as a tool for postoperative assessment of directly affected masticatory muscles and groups of facial nerve branches
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