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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1809047
Original Article

Comparative Analysis of Bite Force after Cranioplasty with and without Temporalis Dissection in Large Skull Defects Caused by Decompressive Craniectomy

Soumya Deepta Nandi
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
,
Raja K. Kutty 
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
,
Jyothish Laila Sivanandapanicker
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
,
Sunilkumar Balakrishnan Sreemathyamma 
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
,
Raj S Chandran
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
,
Rosebist Pathrose Kamalabai
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
,
Libu Gnanaseelan Kanakamma
2   Department of Preventive Medicine, Government Medical College, Trivandrum, Kerala, India
,
Rajmohan Bhanu Prabhakar
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
,
Sureshkumar Kunjuni Leela
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
,
Anilkumar Peethambaran
1   Department of Neurosurgery, Government Medical College Trivandrum, Trivandrum, Kerala, India
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Abstract

Introduction

Cranioplasty involves repairing the skull defect using an autologous bone flap or synthetic molds. The temporalis muscle, detached during decompressive craniectomy (DC), may be reattached to the bone flap for better cosmetic reconstruction. Along with the masseter and pterygoid muscles, the temporalis muscle significantly contributes to the human bite force. In this study, we analyze patients' bite force in which the temporalis muscle was either dissected and reattached or left undisturbed during cranioplasty.

Materials and Methods

All patients who previously underwent DC for traumatic brain injury or stroke were grouped into two, depending on the method of cranioplasty. In group 1, patients underwent temporalis muscle dissection and reattachment to the bone flap or prosthesis. In group 2, the temporalis muscle was left undisturbed. The bite force of the subjects was measured bilaterally in both groups by a gnathodynamometer before cranioplasty and 3 months after the surgery. We compared the difference in bite force of the subjects individually on both sides, preoperatively and postoperatively, as well as between the groups.

Results

This study included 36 patients over 18 years of age, with 18 patients in each group. Preoperatively, the bite force of all the subjects was decreased on the side of the DC compared with the normal side. After cranioplasty, the bite force significantly improved compared with preoperative values in both groups.

Conclusion

Temporalis dissection can be safely done during cranioplasty. There is improvement in bite force after cranioplasty with or without temporalis dissection.

Keywords

decompressive craniectomy - cranioplasty - temporalis dissection - bite force


Publikationsverlauf

Artikel online veröffentlicht:
09. Mai 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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