Endoscopic nasofrontal disjunction.

Disjunction of the nasofrontal junction was performed under endoscopic control in three patients who underwent a monoblock nasal framework osteotomy and two patients who underwent a modified Le Fort type II osteotomy through a small midscalp incision, a stub wound at the root of the nose, and an intercartilaginous incision. A bilateral intercartilaginous incision and nasal root stub wound were used in one case. An osteotomy of the nasal root was performed using a specially designed detachable osteotomy consisting of a thin staff and large handle. The end of the staff was inserted through the access incision and pulled through a stub wound created in the nasal root. The staff was then attached to the handle, and the osteotomy was performed under endoscopic control. This approach minimizes the surgical scar, the area of the subperiosteal dissection, and postoperative swelling of the face, in comparison with the coronal approach.