Assessing Preventative and Postoperative Interventions for Temporal Wasting Following Neurosurgical Intervention: A Systematic Review

Objective: To evaluate preventative and corrective techniques for postoperative temporal wasting. Data Sources: PubMed, Cochrane, Web of Science, and SCOPUS databases. Review Methods: Included studies mentioned temporal wasting and its synonymous terms, were associated with a neurosurgical intervention, or discussed preventative or corrective techniques for temporal wasting. Results: A total of 57 studies were included, comprising 2378 patients with a mean age of 42.03 years. Patient sex was reported in 52 papers, and 52.8% (1091/2078) were female. Most studies were case reports and case series (n = 29). The most common operative interventions performed were craniotomy (648/2378, 27.2%) and craniectomy (307/2378, 12.9%). Temporal wasting was noted in 397 of 1241 (32.0%) patients following neurosurgical procedures. Of patients receiving preventative techniques such as modified approaches to pterional craniotomy or customized implants, 17.7% (191/1077) reported temporal wasting. Reconstructive techniques included implants (n = 20 studies), autologous fat grafting (n = 5 studies), free or pedicled flap (n = 7 studies). Patient satisfaction was mentioned in 19 studies (565 patients). Within this cohort, 31 (5.5%) patients experienced postoperative temporal wasting. However, 448 (79.3%) were satisfied with their postoperative outcomes. Complications after both preventive and corrective techniques were reported in 124 (5.2%) patients, of which need for an additional reconstructive procedure was most common (29/124, 23.4%) followed by infection (23/124, 18.5%) and wound dehiscence (23/124, 18.5%). Conclusion: Temporal wasting is a common outcome after neurosurgical procedures. Fat grafting, implants, and free flap procedures have been used to achieve satisfactory outcomes.