Postoperative changes in occlusal force after craniotomy in older adults: A prospective study

• Occlusal strength and nutritional status after craniotomy decline in the elderly. • No prior study has quantitatively evaluated occlusal strength after craniotomies. • Limited attention is paid to craniotomy’s effects on oral function in the elderly. • The study underscores the importance of enhancing occlusal strength after surgery. This prospective observational study aimed to evaluate how craniotomy with temporal muscle transection affects occlusal force and nutritional status in elderly patients. Given the small sample size (n = 10) and the paired nature of the data, the Wilcoxon signed-rank test was used to compare preoperative and postoperative occlusal force values. We prospectively analyzed 10 patients aged ≥65 years. Occlusal force was measured preoperatively and at 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively using a specialized device. Nutritional status was assessed via blood tests for total protein and albumin levels at each follow-up. In addition, temporal muscle thickness was objectively evaluated using axial CT scans preoperatively and at 12 months postoperatively. Statistical analysis was conducted using the Wilcoxon signed-rank test (p < 0.05). Occlusal force significantly declined at 1 week and 6 months postoperatively (both p = 0.037) but recovered to preoperative levels by 12 months. CT-based measurements showed no significant atrophy of the temporal muscle. Albumin levels decreased at 3 months (p = 0.024), while total protein remained stable. Aspartate aminotransferase and alanine aminotransferase levels were significantly reduced at 1 (p = 0.08 and 0.08), 6 (p = 0.005 and 0.035), and 12 months (p = 0.021 and 0.037). Sodium levels increased at 1 (p = 0.046), 6 (p = 0.046), and 12 months (p = 0.047). Craniotomy in elderly patients leads to temporary occlusal weakness and nutritional decline, highlighting the need for clinicians to monitor occlusal strength and nutritional markers, such as albumin. Our findings emphasize the importance of postoperative occlusal training and nutritional management to optimize recovery.