Background and purpose

The purpose of this study was to introduce and evaluate a small technical nuance –the terminal subpericranial technique– while doing bifrontal craniotomy, to adequately protect the terminal twigs of the facial nerve.

Methods

While doing bifrontal craniotomy the galeo aponeurotic flap is separated from the underlying pericranium in the loose areolar tissue only till 1.5 cms above the supraorbital margin.A single institutional retrospective review of 22 patients who underwent bifrontal craniotomy using bicoronal flaps between 2014 and 2017 were conducted. The patients were divided in to two groups based on whether this technique was adopted (group1) or not (group2). The two groups were compared in terms of post operative facial paralysis if any, graded by House–Brackman scale.

Results

There were no facial palsy in group1, but two in group2 had facial palsy (15%).

Conclusion

While doing bifrontal craniotomy, terminal facial nerve twigs can be adequately safeguarded by using the above technique.