How Much Does Temporal Bone Thickness Contribute to Temporal Reduction For Head Width Narrowing?
Q: Dr. Eppley, I have some questions about temporal reduction”
1. In regards to the convexity that starts above my ear, how much does the temporal bone contribute to the convexity, is the convexity all muscle whilst the temporal bone is straight. Please review my cat scans to confirm what my condition is.
2. Have you ever worked on patients where you removed/reduced the anterior section of the temporalis muscle as well as the posterior section and whether they had any post op complications such as jaw movement, lack of blood circulation with the scalp, hair loss etc?
3. How thick is the temporal bone, is there enough thickness to burr down the temporal line or the temporal bone itself 4. Based off the concept with form following function, considering how the temporal bone & temporal line had expanded due to the well developed temporalis muscles. Down the track after surgery, if I constantly wore a hat tight enough, not to the point of cutting circulation of course, can I reverse the growth and reduce the width of the bone?
A: In answer to your questions:
1) Both the muscle and the bone contribution to the width of the head above the ears. In most people, and you are no exception, they share equally in that effect. The difference in deciding to treat muscle, bone or both is really not what the contribution of the bone is. But whether one can accept an incision on the side of the head to do the bone burring. While muscle removal can be done with a hidden and virtually unfindable scar, the bone must be treated more directly and not from a remote hidden incision.
2) Anterior temporal muscle reduction can be done but it is done differently as it requires a direct incisional approach to do so. Whether it is done in conjunction with posterior muscle removal or by itself, it will definitely have a short term effect of restricting jaw movement in the early recovery period as the bulk of the working part of the muscle (70%) lies in the larger anterior section. I have done both together before but be aware of the short term jaw stiffness that will ensure by so doing.
3) In my observation and experience the thickness of the temporal bone does not allow for much reduction. The temporal bone is the thinnest of the external skull bones.
4) You will not reverse or change the shape of the temporal bone by compression. That only works in infants and very young children where the bones are still forming. But It will not affect the developed adult skull bone.
Dr. Barry Eppley