The coronal or bitemporal approach is used to expose the anterior cranial vault, the forehead, and the upper and middle regions of the facial skeleton.
The coronal or bitemporal approach is used to expose the anterior cranial vault, the forehead, and the upper and middle regions of the facial skeleton.
The glabellar approach can be particularly advantageous in elderly patients who have developed horizontal glabellar furrows due to the action of the procerus muscle.
This approach may also be considered in order to avoid a coronal incision where only limited exposure is needed in a younger patient with a receding hairline, or in a bald patient.
The glabellar approach can be particularly advantageous in elderly patients who have developed horizontal glabellar furrows due to the action of the procerus muscle.
This approach may also be considered in order to avoid a coronal incision where only limited exposure is needed in a younger patient with a receding hairline, or in a bald patient.
There are two periorbital approaches to the superolateral rim of the orbit:
There are two periorbital approaches to the superolateral rim of the orbit:
When wide visualization of the medial canthal area, lacrimal sac, and medial orbital wall is needed an extended glabellar approach is advantageous.
When wide visualization of the medial canthal area, lacrimal sac, and medial orbital wall is needed an extended glabellar approach is advantageous.
There are three basic approaches through the external skin of the lower eyelid to give access to the inferior, lower medial, and lateral aspects of the orbital cavity:
There are three basic approaches through the external skin of the lower eyelid to give access to the inferior, lower medial, and lateral aspects of the orbital cavity:
Transconjunctival lower-eyelid approaches are performed in several ways: transconjunctival, retrocaruncular, transconjunctival with lateral skin extension, combination of inferior and medial transconjunctival, C-shaped incision.
Transconjunctival lower-eyelid approaches are performed in several ways: transconjunctival, retrocaruncular, transconjunctival with lateral skin extension, combination of inferior and medial transconjunctival, C-shaped incision.
Common indirect approaches for reduction of the zygomatic arch include:
Common indirect approaches for reduction of the zygomatic arch include:
The preauricular approach can be used to access and treat fractures at the root of the zygomatic arch.
The preauricular approach can be used to access and treat fractures at the root of the zygomatic arch.
The external rhinoplasty approach to the nasal skeleton can be used for primary treatment of traumatic injuries and for secondary procedures such as septorhinoplasty to correct posttraumatic nasal deformities.
The external rhinoplasty approach to the nasal skeleton can be used for primary treatment of traumatic injuries and for secondary procedures such as septorhinoplasty to correct posttraumatic nasal deformities.
Endonasal approaches to the nasal skeleton can be used for primary treatment of traumatic injuries and for secondary procedures such as septorhinoplasty to correct posttraumatic deformities.
Endonasal approaches to the nasal skeleton can be used for primary treatment of traumatic injuries and for secondary procedures such as septorhinoplasty to correct posttraumatic deformities.
Maxillary fractures can be accessed via two possible approaches:
Maxillary fractures can be accessed via two possible approaches:
Cases of severe fragmentation/displacement of the zygomaticosphenoid junction involving the greater sphenoid wing result in the loss of this landmark of the skull base.
Restoration of the posterior lateral orbit and the transition into the orbital apex can then be performed via a temporal/infratemporal fossa approach.
Cases of severe fragmentation/displacement of the zygomaticosphenoid junction involving the greater sphenoid wing result in the loss of this landmark of the skull base.
Restoration of the posterior lateral orbit and the transition into the orbital apex can then be performed via a temporal/infratemporal fossa approach.
Facial fractures are often associated with lacerations. These existing soft-tissue injuries can be used to directly access the facial bones for the management of the fractures.
Facial fractures are often associated with lacerations. These existing soft-tissue injuries can be used to directly access the facial bones for the management of the fractures.
The ethmoidal approach allows for excellent visibility in the area of the medial canthus. Unfortunately, it commonly results in a very obvious scar contraction band (web) in the medial canthal area.
This medial canthal band is particularly obvious in younger patients. Therefore, we do not recommend the use of this approach except in circumstances where the other common approaches are inadequate.
The ethmoidal approach allows for excellent visibility in the area of the medial canthus. Unfortunately, it commonly results in a very obvious scar contraction band (web) in the medial canthal area.
This medial canthal band is particularly obvious in younger patients. Therefore, we do not recommend the use of this approach except in circumstances where the other common approaches are inadequate.
