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The Coronal Approach: Anatomic and Technical Considerations and Morbidity

The Coronal Approach: Anatomic and Technical Considerations and Morbidity Abstract • The coronal flap has recently become a preferred approach for the otolaryngologist–head and neck surgeon requiring access to the craniofacial skeleton and orbit. The variety of cases in which it has proven indispensable include craniofacial reconstruction, facial trauma, and tumor resection. This method of exposure has become particularly useful with increased indications for rigid internal fixation and primary bone grafting in the management of complex facial fractures. Our experience is reviewed in terms of indications for and benefits of the coronal approach, with a detailed description of the technique emphasizing anatomic planes and neurovascular structures. Careful attention to the latter should allow prevention of potential complications. (Arch Otolaryngol Head Neck Surg. 1993;119:201-207) References 1. Tessier P, Wolfe SA, trans. Telorbitism, orbital (ocular) hypertelorism . In: Tessier P, Rongier J, Hervouet F, Woiller M, Lekieffre M, Derome P, eds. Surgery of the Orbit . New York, NY: Masson; 1981;17:234. 2. Gruss JS. Fronto-naso-orbital trauma . Clin Plast Surg . 1982;9:577-584. 3. Gruss JS. Nasoethmoid-orbital fractures: classification and role of primary bone grafting . Plast Reconstr Surg . 1985;75:303-315.Crossref 4. Stanley RB. The zygomatic arch as a guide to reconstruction of comminuted malar fractures . Arch Otolaryngol Head Neck Surg . 1989;115:1459-1462.Crossref 5. Gruss JS, Van Wyck L, Phillips JH, Antonyshyn O. The importance of the zygomatic arch in complex mid-facial fracture repair and correction of posttraumatic orbitozygomatic deformities . Plast Reconstr Surg . 1990;85: 878-890.Crossref 6. Kawamoto HK. Late post-traumatic enophthalmos: a correctable deformity . Plast Reconstr Surg . 1982;69:423-430.Crossref 7. Obwegeser HL. Temporal approach to the TMJ, the orbit, and the retromaxillary-infracranial region . Head Neck Surg . 1985;7:185-199.Crossref 8. Johns ME, Winn RH, McClean WC, Cantrell RW. Pericranial flap for the closure of defects of craniofacial resections . Laryngoscope . 1981;91:952-958.Crossref 9. Sullivan WG, Robson MC, Thomas LM. Craniofacial resection and reconstruction of an ethmoid melanoma invading cranium . Head Neck Surg . 1988;10( (suppl 1) ):525-529.Crossref 10. Psillakis JM, Rumley TO, Camargos A. Subperiosteal approach as an improved concept for correction of the aging face . Plast Reconstr Surg . 1988;82:383-392.Crossref 11. Zide BM, Jelks GW. Forehead, temporal region, and cheek . In: Zide BM, Jelks GW, eds. Surgical Anatomy of the Orbit . New York, NY: Raven Press; 1985;2:13-19. 12. Stuzin JM, Wagstrom L, Kawamoto HK, Wolfe SA. Anatomy of the significance of the temporal fat pad . Plast Reconstr Surg . 1989;83:265-271.Crossref 13. Liebman EP, Webster RC, Berger AS, DellaVecchia M. The frontalis nerve in the temporal brow lift . Arch Otolaryngol Head Neck Surg . 1982;108:232-235.Crossref 14. Abul-Hassan HS, vonDrasek Ascher G, Acland RD. Surgical anatomy and blood supply of the fascial layers of the temporal region . Plast Reconstr Surg . 1986;77:17-28. 15. Mitz V, Peyronie M. The superficial musculoaponeurotic system (SMAS) in the parotid and cheek area . Plast Reconstr Surg . 1976;58:80-88.Crossref 16. Shepherd DE, Ward-Booth RP, Moos KF. The morbidity of bicoronal flaps in maxillofacial surgery . Br J Oral Maxillofac Surg . 1985;23:1-8.Crossref 17. Abubaker AO, Sotereanos G, Patterson GT. Use of the coronal surgical incision for reconstruction of severe craniofacial injuries . J Oral Maxillofac Surg . 1990;48:579-586.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

The Coronal Approach: Anatomic and Technical Considerations and Morbidity

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References (19)

Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1993.01880140091014
Publisher site
See Article on Publisher Site

Abstract

Abstract • The coronal flap has recently become a preferred approach for the otolaryngologist–head and neck surgeon requiring access to the craniofacial skeleton and orbit. The variety of cases in which it has proven indispensable include craniofacial reconstruction, facial trauma, and tumor resection. This method of exposure has become particularly useful with increased indications for rigid internal fixation and primary bone grafting in the management of complex facial fractures. Our experience is reviewed in terms of indications for and benefits of the coronal approach, with a detailed description of the technique emphasizing anatomic planes and neurovascular structures. Careful attention to the latter should allow prevention of potential complications. (Arch Otolaryngol Head Neck Surg. 1993;119:201-207) References 1. Tessier P, Wolfe SA, trans. Telorbitism, orbital (ocular) hypertelorism . In: Tessier P, Rongier J, Hervouet F, Woiller M, Lekieffre M, Derome P, eds. Surgery of the Orbit . New York, NY: Masson; 1981;17:234. 2. Gruss JS. Fronto-naso-orbital trauma . Clin Plast Surg . 1982;9:577-584. 3. Gruss JS. Nasoethmoid-orbital fractures: classification and role of primary bone grafting . Plast Reconstr Surg . 1985;75:303-315.Crossref 4. Stanley RB. The zygomatic arch as a guide to reconstruction of comminuted malar fractures . Arch Otolaryngol Head Neck Surg . 1989;115:1459-1462.Crossref 5. Gruss JS, Van Wyck L, Phillips JH, Antonyshyn O. The importance of the zygomatic arch in complex mid-facial fracture repair and correction of posttraumatic orbitozygomatic deformities . Plast Reconstr Surg . 1990;85: 878-890.Crossref 6. Kawamoto HK. Late post-traumatic enophthalmos: a correctable deformity . Plast Reconstr Surg . 1982;69:423-430.Crossref 7. Obwegeser HL. Temporal approach to the TMJ, the orbit, and the retromaxillary-infracranial region . Head Neck Surg . 1985;7:185-199.Crossref 8. Johns ME, Winn RH, McClean WC, Cantrell RW. Pericranial flap for the closure of defects of craniofacial resections . Laryngoscope . 1981;91:952-958.Crossref 9. Sullivan WG, Robson MC, Thomas LM. Craniofacial resection and reconstruction of an ethmoid melanoma invading cranium . Head Neck Surg . 1988;10( (suppl 1) ):525-529.Crossref 10. Psillakis JM, Rumley TO, Camargos A. Subperiosteal approach as an improved concept for correction of the aging face . Plast Reconstr Surg . 1988;82:383-392.Crossref 11. Zide BM, Jelks GW. Forehead, temporal region, and cheek . In: Zide BM, Jelks GW, eds. Surgical Anatomy of the Orbit . New York, NY: Raven Press; 1985;2:13-19. 12. Stuzin JM, Wagstrom L, Kawamoto HK, Wolfe SA. Anatomy of the significance of the temporal fat pad . Plast Reconstr Surg . 1989;83:265-271.Crossref 13. Liebman EP, Webster RC, Berger AS, DellaVecchia M. The frontalis nerve in the temporal brow lift . Arch Otolaryngol Head Neck Surg . 1982;108:232-235.Crossref 14. Abul-Hassan HS, vonDrasek Ascher G, Acland RD. Surgical anatomy and blood supply of the fascial layers of the temporal region . Plast Reconstr Surg . 1986;77:17-28. 15. Mitz V, Peyronie M. The superficial musculoaponeurotic system (SMAS) in the parotid and cheek area . Plast Reconstr Surg . 1976;58:80-88.Crossref 16. Shepherd DE, Ward-Booth RP, Moos KF. The morbidity of bicoronal flaps in maxillofacial surgery . Br J Oral Maxillofac Surg . 1985;23:1-8.Crossref 17. Abubaker AO, Sotereanos G, Patterson GT. Use of the coronal surgical incision for reconstruction of severe craniofacial injuries . J Oral Maxillofac Surg . 1990;48:579-586.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Feb 1, 1993

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