By Ellis E., Zide M.F.
That includes over four hundred full-color surgical pictures and drawings, this text/atlas is a step by step advisor to the surgical ways used to reveal the facial skeleton. The authors describe intimately the most important anatomic constructions and the technical facets of every method, in order that the healthcare professional can thoroughly achieve entry to the sector of the craniofacial skeleton requiring surgical procedure. This moment variation contains full-color intraoperative images that supplement the surgical drawings. a number of new methods were extra — the transconjunctival method of the medial orbit, subtarsal method of the inner orbit, Weber-Ferguson method of the midface, and facial degloving method of the midface.
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Additional info for Surgical Approaches to the Facial Skeleton
Example text
38 SURGICAL ANATOMY Lower Eyelid In addition to an understanding of the anatomy described in Chapter 2 for the lower eyelid approach, the transconjunctival approach requires understanding of a few additional matters. Lower Lid Retractors. During full downward gaze, the lower lid descends approximately 2 mm in conjunction with movement of the globe itself. The inferior rectus muscle, which rotates the globe downward, simultaneously uses its fascial extension to retract the lower eyelid. This extension, which arises from the inferior rectus, contains sympathetic-innervated muscle fibers and is commonly called the capsulopalpebral fascia (Fig.
Figure 4 2 Incision through periosteum along lateral orbital rim and subperiosteal dissection into lacrimal fossa. Because of the concavity just behind the orbital rim in this area, the periosteal elevator is oriented laterally as dissection proceeds posteriorly. 53 Step 4. Subperiosteal Dissection of Lateral Orbital Rim and Lateral Orbit Two sharp periosteal elevators are used to expose the lateral orbital rim on the lateral, medial (intraorbital), and, if necessary, posterior (temporal) surfaces (Fig.
Figure 2 30 Dissection to the level of the frontozygomatic suture. The tissues superficial to the periosteum are retracted superiorly with a small retractor and an incision through periosteum is made 3 to 4 mm lateral to the lateral orbital rim. Subperiosteal dissection exposes the entire lateral orbital rim. Dissection into the lateral orbit frees the tissues and allows retraction superiorly. No lateral canthopexy is necessary if careful repositioning and suturing of periosteum along the lateral orbital rim are performed.