REHABILITATION OF PATIENTS WITH EXTENDED FACIAL AND CRANIOFACIAL RESECTION

Surgery of benign and malignant disease of the nose and sinuses can re sult in disfigurement and disability. Many patients have speech, masti cation, and swallowing problems, anosmia, and pain. If the orbit is re tained, visual loss, dystopia, diplopia, and epiphora can occur. This study reviews the senior author's experience with 34 patients over the last 18 years. Group and case analyses demonstrate that in patients w ith cancer, the eye can be preserved if one anatomical boundary is ret ained beyond a negative frozen section margin. Dystopia can be prevent ed by reconstruction of the floor with skin and fascial grafts or flap s. Epiphora can be reduced by repair of the medial canthus and dacryoc ystorhinostomy. Evidence is presented for prosthetic management of spe ech and swallowing and restoration of cheek contour, Case examples are used to illustrate the surgical techniques.