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Coronal approach

Subperiosteal Exposure of the orbits and upper midface

Further retraction of the flap inferiorly is accomplished by subperiosteal dissection into the orbits.
The periorbita is dissected 180° off the adjacent superior medial and lateral orbital walls into the midorbit as shown after release of the supraorbital nerves.

If necessary the dissection can continue even deeper into the orbit.

For exposure of the nasofrontal and the nasoethmoid region as well as the medial orbit, the trochlea needs to be disinserted together with its connective tissue attachments from the frontal bone.
Short sagittal incisions through the periosteum over the midline of the nasal dorsum will release the soft-tissue tension and facilitate the retraction of the coronal flap down to the osteocartilagineous junction.