The coronal or bitemporal incision is used to approach the anterior cranial vault, the forehead, and the upper and middle regions of the facial skeleton.
The frontal craniotomy approach is appropriate for medium size tumors that do not encroach on the optic nerves or cavernous sinus.
Extended frontal craniotomy
The extended frontal craniotomy (extended subfrontal) approach provides the widest access for large tumors and those near the optic chiasm.
On the nasal side, the tumor can be exposed via a lateral rhinotomy incision or endonasally with endoscopes.
The Weber Ferguson approach is indicated for access for tumors involving the maxilla extending superiorly to the infraorbital nerve and into or involving the orbit. It provides a wide access to all areas of the maxilla and orbital floor.
The use of a lip splitting incision with a lateral extension into the neck incision allows for the elevation of a cheek flap and exposure of the hemi mandible.
This approach allows access to virtually any area of the oral cavity or oropharynx but, does require the release and pull through of advanced oromandibular tumors into the neck.