MIDFACIAL DEGLOVING APPROACH TO THE NOSE, SINUSES, AND SKULL BASE

Thirty-seven patients with a variety of neoplastic, vascular and traum atic lesions of the midfacial skeleton, orbits, and central compartmen t of the anterior and middle cranial fossae were managed surgically vi a the midfacial degloving approach. Excellent exposure was achieved in all patients. Complete removal of the lesion was achieved in all pati ents with neoplastic disease. Successful repair of the defect was achi eved in all patients with traumatic injuries. The most common complica tion related to midfacial degloving was temporary infraorbital anesthe sia or hypesthesia. Only one patient developed symptomatic nasal valve stenosis. Midfacial degloving has important advantages over other pro cedures, especially in cases where bilateral surgery is required or wh en the avoidance of midfacial incisions and scars is important. In the subgroup of inverted papilloma, midfacial degloving is currently our procedure of choice for en-block medial maxillectomy and ethmoidectomy .