Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T11:41:35.369Z Has data issue: false hasContentIssue false
  • English
  • Français

The midfacial degloving approach to sinonasal disease

Published online by Cambridge University Press:  29 June 2007

David J. Howard  and
Valerie J. Lund
David J. Howard
Affiliation:
London
Valerie J. Lund*
Affiliation:
London
*
Miss Valerie J. Lund, M.S., F.R.C.S., Senior Lecturer in Rhinology, Institute of Laryngology and Otology, 330 Grays Inn Road, London WCIX 8DA
Get access Rights & Permissions [Opens in a new window]

Abstract

The midfacial degloving approach was first described by Casson et al. in 1974 but despite a number of papers in the American literature advocating its use, it has not gained popularity in Europe. The advantages and application of the technique are presented in 36 patients, ranging from 7–78 years of age. The approach is ideally suited for extensive benign lesions in the nasal cavity, ethmoid and sphenoid sinuses and enables access to the nasopharynx and infratemporal fossa whilst avoiding an external incision. These lesions have included angiofibroma (13 cases), inverted papilloma (five cases), a variety of cysts (three cases) and six miscellaneous cases of benign pathology. Malignant lesions which have not breached the anterior cranial fossa may also be removed, up to and including bilateral maxillectomy (nine cases) and this can be combined with orbital clearance. The approach may be repeated if necessary and is associated with few significant complications though vestibular stenosis, oro-antral fistula, nasolacrimal damage and upward rotation of the nasal tip may occur. Strategies to avoid these problems can be undertaken and long-term cosmetic results are excellent.

Keywords

Sino-nasal neoplasiasurgical approach
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 106 , Issue 12 , December 1992 , pp. 1059 - 1062
Copyright
Copyright © JLO (1984) Limited 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, G. W., Siegel, G. J. (1981) The sublabial approach for extensive nasal and sinus resection. Laryngoscope, 91: 1635–1640.CrossRefGoogle ScholarPubMed
Anand, V. K., Conley, J. J. (1983) Sublabial surgical approach to the nasal cavity and paranasal sinuses. Laryngoscope, 93: 1483–1484.CrossRefGoogle Scholar
Casson, P. R., Bonnano, P. C.Converse, J. M. (1974) The midface degloving procedure. Plastic and Reconstructive Surgery, 53: 102–103.CrossRefGoogle ScholarPubMed
Converse, J. M. (1950) Restoration of facial contour by bone grafts introduced through the oral cavity. Plastic and Reconstructive Surgery, 6: 295.CrossRefGoogle ScholarPubMed
Denker, A. (1906) Ein neuer weg fur die operation der malignent nasen tumoren. Munscher Medizinische Wochenschrift, 20: 20–26.Google Scholar
Maniglia, A. J. (1986) Indications and techniques of midfacial degloving. Archives of Otolaryngology Head and Neck Surgery, 112: 750–752.CrossRefGoogle ScholarPubMed
Portmann, G., Retrovey, H. (1927) Le cancer du nez. Gaston Doin et Cie, Paris.Google Scholar
Price, J. C. (1986) The midfacial degloving approach to the central skull-base. Ear Nose Throat Journal, 65: 174–180.Google Scholar
Romo, T., Foster, C. A., Korovin, G. S., Sachs, M. E. (1988) Repair of nasal septal perforation utilizing the midface degloving technique. Archives of Otolaryngology Head and Neck Surgery, 114: 739–742.CrossRefGoogle ScholarPubMed
Sachs, M. E., Conley, J., Rabuzzi, D., Blaugrund, S., Price, J. (1984) Degloving approach for total excision of inverted papilloma. Laryngoscope, 94: 1595–1598.CrossRefGoogle ScholarPubMed