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February 1993

The Coronal Approach

Arch Otolaryngol Head Neck Surg. 1993;119(2):140. doi:10.1001/archotol.1993.01880140016002

Most of us in otolaryngology are familiar with the coronal flap as a method of elevating the brow in cosmetic surgery and its use in frontal sinus procedures. Drs Frodel and Marentette1 discuss the enlarging role of this approach in craniofacial reconstruction, facial trauma, tumor resection, secondary deformity corrections, and surgery of both the anterior and lateral skull base as well as in aesthetic surgery. They point out that the primary concern of most surgeons using this approach is the potential injury to the frontal branch of the facial nerve.

The more limited coronal flaps used for brow lift and frontal sinus procedures involve less risk to the frontalis nerve, because the dissection is carried in the subgaleal areolar tissue under the frontalis muscle and, in most instances, does not extend laterally or superficially enough to damage the frontalis nerve. The more extensive dissections as described by Drs Frodel

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