On the Origin of Bitemporal Hollowing

Abstract

Temporal hollowing seems to be of bony origin and can be explained by skeletal growth inhibition in the affected area. When present immediately after operation, they seem to persist through the years, which makes surgical skill another factor of importance.

Trigonocephaly: Results after surgical correction of nonsyndromatic isolated metopic suture synostosis in 54 cases

“…The posterior edge of the forehead in the temporal region could end up not extending sufficiently backwards to support or fill the temporal area, leaving a temporal depression (Persing et al, 1994;Oh et al, 2006;van der Meulen et al, 2009). So, the posterior edge in the temporal area should be extended to enlarge the bitemporal deficiency.…”

“…In contrast to Aryan, van der Meulen describes that the iatrogenic damage to the temporal bone for instance could result from the two osteotomies that are performed in that area in a parallel horizontal plane to mobilize the supraorbital bandeau. For him, temporal hollowing seems to be of bony origin and can be explained by skeletal growth inhibition in the affected area (van der Meulen et al, 2009). The surgical technique seems to be relevant in the origin of bitemporal hollowing.…”

“…The surgical technique seems to be relevant in the origin of bitemporal hollowing. The choice of operative technique could result in an underestimation of the lateral expansion needed to correct the initial dysmorphology (van der Meulen et al, 2008;van der Meulen et al, 2009).…”

“…They also had no major complications, performed no planned reoperations, and only one patient (5%) required unplanned reoperation (Sloan et al, 1997) Total reoperation (reoperative fronto-orbital remodelling and calvarial vault reshaping) was necessary in two patients (9%) of Cohen's Collective (Cohen et al, 1994). Bitemporal hollowing is common after surgical correction of metopic synostosis (Persing et al, 1994;Oh et al, 2006;van der Meulen et al, 2009). Hollowing is usually located just lateral and slightly cranial to the lateral apex of the eyebrow.…”

A new quantitative image-based method for evaluation of bony temporal hollowing in metopic synostosis

“…The disorder is characterised by a triangular forehead caused by restricted growth of the frontal bones, a compensatory increased interparietal width, a midline bony ridge, and ocular hypotelorism involving a reduced distance between the eyes and deformation of the orbital shape [3]. Temporal hollowing could be caused both by soft tissues and bone, but in metopic synostosis the bitemporal hollowing is caused by the shape of the temporal skeleton itself [4].…”