Preface

A /T,m> «lisons cm m for exposing lIil1 fatiol skclci^n. Treamicni at fací at fracrijrev lYlriuH^criieni of p». minimal >, lIí^m.^-. tiföcüc onlay m\.\ FL-uummrnlf tiroccdure<, declive osibciomifs, [(VQtnicnl ofsrcoiifiary irnumatie deformities sucv&l« eiio| Lindums, phtLtrttciit of endosteal implants, and a Host oí other reconstructive procedure* r^iuin: ap-

pwlmlits to the facial rftniawbtk Mu in jpproachch m a given ¿kclcial rëg, are pong him The ohaicu is usually hascil On llic surgeon's (mini nu. fcxpeticpte, mid bias 1lj| book j.h^ not advocate one apprutch overrun her. althoiu| the adpLriligiis md disadvantage* of each opproadi uiv Iftjcd. Wc mai neon the age-old belief Lli.Lt "nlnns ruad* lend 10

Kenne." 111 lis. if ii' purpure ci i this buolt in dfSVliijt iii d£ldí] i kl.' iiiiiiihiiil' antl [(¡clinic 'f aspwti Li I m Wt o[ I ht Cditiimmlj usclI Surgiatí lippr^khes I1'1 Ilisí:lI skeleton Wei purposely do 11 ut present everj ùppronfh Kvmjse many |re Su ¡ÈÈnivttsally used, oí arc so -- i i iij«-rur that nwiing nÈcds bo ^iLd. The (tpproasLhes pifis^id, in this t>OLik. however, allpu ■ III- surgeon Cdin|]k-k- access lo täii; mniofudlll j¡keklon for any >kc!clal pmeediiTt ilial ií, Itcirijjj performed.

We Ii luv oUicñfflftcd IfLU» Üie banning Ki iiKLkf Surgical Appiwt lws to ihr- Fminl Sktfelon different from olher books Lllíit much on [his $ubjt<H> Most iKiofcs lhal diücuss surgical approaches dp so m the conicxl of ilk- surgical ñj^K^dupe beipÉ DníMnlcil lJur in stance, a h(R>k mi fjjciul tïueni re? usually snrgiip appiroiôjrhfs tu 4 particular írjtr tun:. The mi deal Ippram:^ hn^ívír. i-- n<n gciftpily giv^n iiinsh cons ¡derritan nr presented iri ^sufficient detail for ihe mi vice. Oiu- is often ten with tlie question, "Hó^ Jid the uLLtlior get from the sJán m iliui point im ihe -keleion.*" Wo ¡deration nf why one is exposing il il- skeleton, jiuf ilus^cdl-M.- uiû appftMChtí írt ¿fc^ Jatuil sli tluir ihc noVtize t\Lti sa fu h approach tile Íaíkt skeletsm by follow irtj» cmr lücp-tiV-SIcp tlcsuriplnm.

This ihhik ¿lsmimcm th:LL lili? jvlitlcr li:iv Ii.lsll utxffiniianding ofittjgiiiilul liiutuítiy, t4>pct ililly üsltolo^y. The HjAtomíc stüjaclun» ni yivalu.hi irtîïtil arí ijllitu^m l'or weh surgical appniuh Tile in^tk ülwi juswcs tli.it ikf reader há-s dfilycrldpfd n kill s fur i lie l"iiv-lui liitfihmlng qf soft luslk-.s. wc hnvc sü^ge^í the bseiaj ïn>ëumâu ihn* iy|liovc liiuiid um: tul iw irilimi);;, ictîji;tiiiyr and manipulating (iii- i¡n vil- s ¡n val ved with «dtih s(irti¡l-¡ij pnudi. rveouiil/it^ tlial nlhers jùï ¡lIshi uppropi nikv Hie book also ultimes ilml ute rätdcr h skilled in facial sofi tissue closurv wcdiji inn ihsmuhs skin cdtfun: wâinîajks uss^ina'd with the HFipÁpchtüt iifiíess Lbé)| di tier írüiu irpiiiint skin ijlcstirci ■

Tills book contains u chairs, t.' of which describe i ffKicine su^gjtcul Jipprnicli The firn-t cheplcr diss'LLsics bask punuiplev n^oh^l in |ÚÍ£<ca1 t)pproni¿lnij<¡ 11^' rrirjûJti-i fit- 1.1 chApierf are nrji-in^eLl lnii> seeiums, bused prcdtKtiinüJÍjjíy un Ule rc^ »un t>1 ÜK Ijl-l' beinj! exposed Owfl nion: tliari unl- Mirerai opproutUl is pfcflçnlcd for ejcli iC^iLih, with the L-lmite kli tn \uc nuntmn, ^vl: Liiiwnpt to point um Iho adv»illi^o> .trul diMdvania^cs ni t; lis h ns h if jtifewírilcíi

Ih>|m- ihm Siii\->> ,it \fipnrm In \ ti ' ((« I-'m mt SkéfèUtti vtJII hcunnnJ li hvlpftll l»imi-pi,iiiii hi L-s)ii>-i,hlk ii--.lh^:l-(iii ■ in irjiiuup. tun alio H-. ll ready lek-ieik'r lo.othur.i palla*, TrjüJJi Edwaffl ííllis III

Contents

Section I General Principles for Approaches to the Facial Skeleton 1

1 General Principles for Approaches to the Facial Skeleton 3 Section II Periorbita Approaches 7

2 Lower Eyelid Approach 9

3 Transconjunctival Approach 38

4 Supraorbital Eyebrow Approach 51

5 Upper Eyelid Approach 55 Section III Coronal Approach 63

6 Coronal Approach 65 Section IV Transoral Approachs to the Facial Skeleton 95

7 Maxillary Vestibular Approach 97

8 Mandibular Vestibular Approach 109 Section V Transfacial Approaches to the Mandible 121

9 Submandibular Approach 123

10 Retromandibular Approach 139

11 Rhytidectomy Approach 154 Section VI Approaches to the Temporomandibular Joint 161

12 Preauricular Approach 163 Section VII Surgical Approaches to the Nasal Skeleton 187

13 External (Open) Approach 189

14 Endonasal Approach 204 Index 217

i GENERAL PRINCIPLES FOR APPROACHES TO THE FACIAL SKELETON

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