Degree of Frontal Bone Exposure via Upper Blepharoplasty Incision: Considerations for Frontal Sinus Fracture

Michael Kinzinger, Toby Steele, Oliver Chin, Edward B. Strong

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The upper eyelid blepharoplasty incision affords direct access to the frontal bone for skull base surgery and trauma reconstruction with a well-hidden scar. The goal of this study is to quantify frontal bone exposure that can be achieved with an upper eyelid blepharoplasty incision. Design: Anatomic study with human cadaver heads. Setting: UC Davis Medical Center. Subjects/Methods: Fourteen human cadaver heads were used to perform 26 upper blepharoplasty approaches. Exposure was measured with virtual planning software to create virtual reference points at the midline of the superior orbital rim. Surgical navigation was used with a 3-dimensionally printed drill model to measure the maximum exposure achievable relative to the virtual reference point at 5 standardized angles. Results: Mean ± SD exposures at medial 60°, medial 30°, 0°, lateral 30°, and lateral 60° were 16.1 ± 1.3 mm, 17.8 ± 1.3, 18.3 ± 1.4, 19.3 ± 1.9, and 20.9 ± 1.9, respectively. Significant differences were detected between exposures at 60° laterally and 60° medially and between exposures 60° laterally and 30° medially (P <.05). Conclusions: The upper eyelid blepharoplasty incision provides direct surgical access to the inferior frontal bone. Access was greatest with far lateral extension (mean, 20.9 mm) and most limited with far medial extension (mean, 16.1 mm). Treatment of injuries above this level could be achieved with additional percutaneous incisions for screw placement.

Original languageEnglish (US)
JournalOtolaryngology - Head and Neck Surgery (United States)
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Keywords

  • blepharoplasty
  • facial fracture
  • frontal sinus fracture
  • trauma

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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