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October 1989

Hemicoronal Flap Approach for Lateral Orbitotomy

Author Affiliations

Houston, Tex

Arch Ophthalmol. 1989;107(10):1421-1422. doi:10.1001/archopht.1989.01070020495012

To the Editor.  —In the December 1988 issue of the Archives, Stewart et al1 described and illustrated the technique of a bicoronal scalp flap to perform a lateral orbitotomy. In addition to the advantage of expanded extraorbital exposure, the technique also avoids facial scars that may be troublesome to selected patients. We offer a modification of this approach, which is helpful in selected patients. Since most surgical orbital disorders are unilateral, we have found that a unilateral, Dandy-type scalp flap will offer the same benefits as a bicoronal flap while minimizing surgical time, wound area, and other complications relative to flap size.2The hemicoronal flap is developed via an incision extending from 1 cm below the zygoma and just anterior to the ear, coursing superiorly several centimeters posterior to the hair line, and stopping at the midline (Fig 1). The hemicoronal flap is then developed anteriorly using the

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