Predictors of temporalis muscle atrophy and head asymmetry following frontotemporal craniotomy: A retrospective analysis of clinical factors and volumetric comparison

Pterional and middle fossa craniotomy procedures are both associated with significant TM volume loss and subsequent head asymmetry. Age and preoperative scalp thickness are independent risk factors for the development of TM volume loss and head asymmetry. These findings could contribute to the development of preoperative risk stratification algorithms, enabling neurosurgeons to predict the likelihood of cosmetic disfigurement. This would enhance preoperative counseling for patients undergoing craniotomy procedures, especially for elderly individuals and those with thin scalps. Overall, this study provides valuable insights into prognostic factors that may impact the development of poor cosmesis following frontotemporal craniotomy.