Abstract:

Objective

To investigate the effect of high-frequency electrosurgical unit on postoperative temporalis muscle atrophy in frontotemporal craniotomy.

Methods

A total of 91 patients who underwent frontotemporal craniotomy in Neurosurgery Department of Fuyang People's Hospital Affiliated to Anhui Medical University from September 2023 to March 2024 were prospectively selected and randomly divided into two groups using a random number table method： the study group （n=48） using high-frequency electrosurgical unit during surgery and the control group （n=43） using periosteal peeler and bipolar electrocoagulation during surgery. The time taken to separate the temporalis muscle，the amount of bleeding during separation of the temporalis muscle，and the amount of postoperative drainage were compared between two groups. The postoperative imaging data of the patients were collected，and the temporalis muscle volume was measured by three-dimensional reconstruction to compare the degree of postoperative temporalis muscle atrophy between two groups. The perioperative clinical data and followup data of patients were statistically analyzed，and incidence of adverse events such as postoperative mouth opening limitation，facial sensory disturbance，chewing pain，and temporal depression were compared between two groups.

Results

Compared with the control group，the study group had a shorter temporalis muscle separation time，less blood loss during temporalis muscle separation，and less postoperative drainage，and the differences were statistically significant （P＜0.05）； At 1 and 3 months after surgery，compared with the control group，the temporalis muscle atrophy in the study group was more severe，and the difference was statistically significant （P＜0.05）； During the postoperative follow-up period，the incidence of postoperative chewing pain in the study group was higher than that in the control group，and the difference was statistically significant （P＜0.05）.

Conclusion

During frontotemporal craniotomy ，the use of high-frequency electrosurgery to separate the temporalis muscle can effectively shorten the time for separating the temporalis muscle，reduce the amount of bleeding during separation of the temporalis muscle and the amount of drainage after surgery. The rational use of high-frequency electrosurgical unit can alleviate temporal atrophy to a certain extent，reduce the patient's anxiety and improve the patient's quality of life.

Key words: Temporalis muscle, Atrophy, Craniotomy, High-frequency electrosurgical unit, Postoperative complications