Orbital surgery. The technique of coronal scalp flap approach to the qateral orbitotomy

W. B. Stewart, P. S. Levin and B. A. Toth
Department of Ophthalmology, Pacific Presbyterian Medical Center, San Francisco.

Lateral orbitotomy may be performed using a coronal scalp flap to provide exposure of the lateral orbital wall and rim. A coronal incision is made across the scalp. The scalp flap is developed anteriorly to expose the orbital margin from the superior orbital rim to the zygomatic arch. The temporalis muscle is dissected from its bony attachments and bluntly retracted, providing maximal exposure of the lateral orbital wall. The orbitotomy proceeds as required. The case concludes with a layered closure. In selected patients, the coronal scalp flap provides improved exposure and postoperative aesthetics compared with approaches in which the skin and muscle layer are incised directly over the lateral orbit. Complications are infrequent.