Authors of section

Authors

Carl-Peter Cornelius, Nils Gellrich, Søren Hillerup, Kenji Kusumoto, Warren Schubert

Executive Editors

Edward Ellis III, Kazuo Shimozato

General Editor

Daniel Buchbinder

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Glabellar approach

1. General considerations

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.

An example of where a limited exposure may be necessary in the nasofrontal area is a Le Fort II or III fracture.

The most common approach for reduction of NOE fractures is a combined approach of coronal incision, lower eyelid incision, and a maxillary vestibular incision. This combined approach is often required to obtain stabilization of the extensive comminuted fracture. Some surgeons use these combined incisions, but substitute the glabellar approach for the coronal incision.

2. Skin incision

Locating the skin incision
The incision should be planned in the glabellar furrows or, if appropriate, in the region camouflaged by the bridge of eyeglasses.

Location of skin incision

Skin incision
Perform a skin incision with a scalpel along the planned incision line. Sharp dissection can then be carried down through the periosteum.

Skin incision

3. Exposure

Exposure of the bone
Using retractors, the bone can be exposed.

Exposure of the bone

4. Wound closure

A simple layered closure is performed as for any laceration in this area.

Exposure of the bone