Coronal Scalp Flap, for Anterior Orbitotomy

Definition

A surgical procedure elevating a coronal flap to obtain broad access and exposure to the anterior and lateral orbit and surrounding areas.

Indications

This technique is most often used for lateral bony or intraconal lesions to allow broad exposure. It also provides direct and broad exposures for patients who have multiple orbital fractures, including the superior orbital rim or bone, as well as multiple other facial fractures (Nerad 2001; Levine 2003; Paolini et al. 2006).

Contraindication

Contraindication for patients unable to medically tolerate surgery or anesthesia or for those with more localized lesions that may be accessed with a more limited technique.

Techniques and Principles

Under general anesthesia, a coronal flap is elevated beveling the incision to maintain hair follicles. It is then carried inferiorly either in a subperiosteal or subfascial plane taking care to avoid damage to the frontal branch of the facial nerve. The area of interest is exposed as necessary...