Can Skull Width Reduction Be Done By Moving In The Bones?

Q: Dr. Eppley, I have already undergone an ablation of the frontotemporal muscles of the skull to obtain a cranium of less wide appearance combined with a fracture of the zygomatics but I would like to know if it is possible to carry out a bone cranioplasty which will consist of cutting the bones of the skull and to file them to then reattach them with small vices because I find that my skull has not sufficiently lost in width with the procedure of removing the temporal muscles and I would like to be able to file the bone directlyIn advance, thank you for your answer.

A: I am not sure what you mean by ‘ablation of the frontotemporal muscles’ as this would imply electrocautery treatment to induce some muscle atrophy. This is very different and far less effective than temporal muscle removal techniques which create very visually effective head width reductions. So my first question is what was actually done and was the muscle reduction effect maximized as this will always be the most effective approach to skull width reduction. I would have to read the operative note to understand what was actually done.

That being said what you are asking is whether bone flaps can be created and pushed inward as a method to reduce skull width…and the answer is no in adults. The brain occupies the intracranial space and it requires the space that it now has. Any skull bone efforts that impinge on the territory of the brain (aka compress the brain in any way) has adverse medical consequences.

Dr. Barry Eppley

Indianapolis, Indiana