How Predictable is the Coronal Flap? How Should We Consent for Surgery? A Retrospective Study
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Authors
Ayub A.
Holmes S.
Murgatroyd E.
Boutros C.
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Issue Date
2025
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Journal Article
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Introduction: The coronal flap is used for numerous craniofacial trauma indications-central and lateral, upper and midface fracture exposure. Whilst there are several studies on the coronal-flap technique, there is a gap in knowledge of patient aesthetic outcomes and their predictability. Purpose(s): This study attempts to quantify risk profiles and thus inform patient consent in patients where a coronal incision is indicated. Method(s): A retrospective study was conducted using data from patients treated via coronal access between January 2021 and January 2024. Data collected included demographic information, anatomical diagnosis, and operative variables. Outcome analysis included surgical outcomes and patient satisfaction according to the "Patient and Observer Scar Assessment Scale." Results: Fifty patients were reviewed with a minimum post-operative interval of >6 months. Hair Loss: 71.4% of patients did not experience residual baldness after surgery. Visible scarring occurred in 28.6%, with the majority in the temporal region. None of these patients requested scar revision. 100% of patients favored a zig-zag incision for hair re-growth. Incision Location: 71.4% of patients had posterior incisions. 93.8% expressed satisfaction with the aesthetic outcome. Scarring and Healing: 85.7% of patients reported satisfaction with the scar appearance. 93.8% stated they would choose the same surgical approach again. In all cases, surgical access to hard and soft tissues was excellent and achieved the target outcome. Conclusion(s): Coronal access is a predictable incision that provides full access to both hard and soft tissues, allowing for anatomical and enhanced soft tissue resuspension. The best results were influenced by relatively posteriorly placed incisions using a zig-zag pattern. Female patients, in particular, benefited from long hair, which afforded a greater opportunity to cover the scar.Copyright © 2025
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International journal of oral and maxillofacial surgery
Volume
54