The coronal incision: sinusoidal, sawtooth, and postauricular techniques

The coronal incision is a popular and versatile surgical approach for access to the cranial vault and the upper two thirds of the facial skeleton. It provides excellent exposure to allow neurosurgical access, craniofacial osteotomies, repair of facial fractures, calvarial bone grafting, and cosmetic procedures such as the forehead lift. Since the introduction and acceptance of the coronal approach, a variety of modifications of the incision have been used, including methods for camouflaging the incision in the hair. To quickly and easily produce a sinusoidal or sawtooth coronal incision line with or without postauricular extension, a tape measure is positioned at the level of the anteriormost point of the auricular helix. A mark is made every 2 cm on alternating sides of the tape measure. The tape measure is advanced coronally until the vertex of the skull is reached, and the procedure is repeated on the contralateral side. After the tape measure is removed, the resulting regularly spaced marks are connected in a sinusoidal or a sawtooth fashion. A postauricular incision can be easily extended from either the sinusoidal or sawtooth coronal template.