Facial translocation approach to the skull base: The viability of translocated facial bone graft

OBJECTIVES: A retrospective review of 56 patients who were operated through a facial translocation approach was carried out to assess the viability of the translocated facial bone segment. METHODS: Eleven patients had preoperative radiotherapy and 26 had postopera tive radiotherapy. In 14 patients the translocated bone segment was kept at tached to the anterior cheek, and in 42 patients the bone segment was detac hed and then implanted. A vascularized flap was used to obliterate the defe ct in the paranasal sinuses in 15 patients. RESULTS: Twelve (21.4%) patients had devitalized bone segment and required sequestrectomy. The incidence of devitalized bone segment was higher in the patients who received postoperative radiotherapy (P = 0.04) and lower in t he patients in whom the defect in the paranasal sinuses was reconstructed w ith a vascularized flap (P = 0.006). CONCLUSIONS: The translocated facial bone segment should be kept attached t o the cheek soft tissue when possible, or the defect in the paranasal sinus es should be reconstructed with a vascularized flap.