Lateral Canthal (DLC) Approach to the Zygomaticotemporal Branch of the Trigeminal Nerve (Hamawy-Amirlak Technique)


Fig. 15.1

The exit point of the ZTBTN is marked by the star at 17 mm posterolateral and 6.5 mm cephalad to the palpebral fissure. A blue line marks the transverse lateral canthal extension incision


../images/481431_1_En_15_Chapter/481431_1_En_15_Fig2_HTML.png

Fig. 15.2

1 cm transverse lateral canthal extension incision is marked in black. Note that the patient here had site 5 surgery first


../images/481431_1_En_15_Chapter/481431_1_En_15_Fig3_HTML.png

Fig. 15.3

Further cadaveric exposure by dissecting to show the relationship of the zygomaticotemporal branch of the trigeminal nerve (black arrow) and the lateral orbital rim (blue arrow)


../images/481431_1_En_15_Chapter/481431_1_En_15_Fig4_HTML.png

Fig. 15.4

Live patient with exposure via the transverse lateral canthal extension incision and Ragnell retractors. The main branch of the ZTBTN is exposed after dissecting down to the periosteum of the LOR and then around the LOR subperiosteally


../images/481431_1_En_15_Chapter/481431_1_En_15_Fig5_HTML.png

Fig. 15.5

The ZTBTN can then be grasped and avulsed with traction neurectomy with a pair of heavy hemostats


../images/481431_1_En_15_Chapter/481431_1_En_15_Fig6_HTML.png

Fig. 15.6

Right angle is used to sweep behind the rim in case of any accessory nerves



15.1.7 Postoperative Management


Tags:
Dec 23, 2019 | Posted by in Reconstructive surgery | Comments Off on Lateral Canthal (DLC) Approach to the Zygomaticotemporal Branch of the Trigeminal Nerve (Hamawy-Amirlak Technique)

Full access? Get Clinical Tree
Get Clinical Tree app for offline access