The Effect of Temporal Muscle Suspension of Temporal Hollowing

NCT ID: NCT03324516

Last Updated: 2020-07-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-01

Study Completion Date

2021-01-01

Brief Summary

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The primary objective is to identify which patients undergoing a traditional pterional approach with 2 different surgical techniques for TMS (Temporal Muscle Suspension) will develop TH (Temporal Hollowing. Pre and post-operative CT scans will be reviewed and analysis with previously proven metrics will be performed.

Detailed Description

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The pterional approach is an indicated neurosurgical approach commonly used for anterior circular aneurysms, suprasellar lesions, and medial sphenoid wing tumors (1,2). A curvilinear incision from the midline widows peak and extending laterally to 1 cm anterior to the tragus of the ear, terminating within a skin crease, with preservation of the superficial temporal artery if possible. The temporalis fascia is encountered and divided. Either the entire temporalis muscle can be elevated or a cuff of temporalis muscle can be left on the cranium to facilitate closure and suspend the temporalis muscle. Subperiosteal dissection of the muscle is performed and the craniotomies are then accomplished.

Reconstruction of the pterional approach can be accomplished with bony fixation of the bone flap. However, the TMS can be performed by:

1. Resuspension of the temporalis muscle to the cuff of muscle left on the temporal crest or
2. Suturing the temporalis muscle directly to one of the bone plates that is used to for fixation.

The purpose of this prospective study is see if traditional techniques to the closure and temporal muscle suspension (TMS) after the pterional approach will show any differences in post-operative temporal hollowing (TH).

Conditions

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Temporal Wasting

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Patients will be given assigned a research limb the morning of the surgery

Study Groups

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Experimental Group

Patients included in this arm will undergo a traditional bony pterional approach for their craniotomy. A superior cuff of temporal muscle will be left attached to the temporal bone.

Group Type EXPERIMENTAL

Re-Suspension of the temporal muscle after a craniotomy.

Intervention Type PROCEDURE

The temporal muscle cuff will be used to re-suspend the temporal muscle after a traditional craniotomy.

Control

Patients included into this arm will receive a traditional pterional approach for their craniotomy. The temporal muscle will be detached in its entirety.

Group Type ACTIVE_COMPARATOR

Traditional re-suspension of the temporal muscle

Intervention Type PROCEDURE

The temporal muscle will be re-suspended to the bone plate that is used to fixate the temporal bone that is removed for the craniotomy.

Interventions

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Re-Suspension of the temporal muscle after a craniotomy.

The temporal muscle cuff will be used to re-suspend the temporal muscle after a traditional craniotomy.

Intervention Type PROCEDURE

Traditional re-suspension of the temporal muscle

The temporal muscle will be re-suspended to the bone plate that is used to fixate the temporal bone that is removed for the craniotomy.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* This study will include all patients over the age of 18 years who qualify for a pterional approach for their neurosurgical pathology.

Exclusion Criteria

* Excluded patients will be protected populations, such as inmates or children. Patients will not be excluded on the basis of pregnancy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Chad Gordon, DO

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins Department of Plastics and Reconstructive Surgery

Locations

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Johns Hopkins Outpatient CENTER

Baltimore, Maryland, United States

Site Status

Countries

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United States

References

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Badie B. Cosmetic reconstruction of temporal defect following pterional [corrected] craniotomy. Surg Neurol. 1996 Apr;45(4):383-4. doi: 10.1016/0090-3019(95)00452-1.

Reference Type BACKGROUND
PMID: 8607091 (View on PubMed)

Figueiredo EG, Deshmukh P, Nakaji P, Crusius MU, Crawford N, Spetzler RF, Preul MC. The minipterional craniotomy: technical description and anatomic assessment. Neurosurgery. 2007 Nov;61(5 Suppl 2):256-64; discussion 264-5. doi: 10.1227/01.neu.0000303978.11752.45.

Reference Type BACKGROUND
PMID: 18091240 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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IRB00120812

Identifier Type: -

Identifier Source: org_study_id

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