Midfacial degloving: an alternative approach for traumatic corrections in the midface

Midfacial degloving was used as an approach in 14 patients to correct post- traumatic deformities in the midface. In eight patients, deformities in the naso-orbito-ethmoid region were corrected by orbitonasal osteotomy, teleca nthus correction, orbital grafting and nasal augmentation procedures. Zygom atic osteotomies were performed in five patients with orbitozygomatic defor mity. In one patient, a midface fracture (Le Fort II/III) was reconstructed after midfacial degloving. By combination of transoral vestibular, intrana sal and preseptal transconjunctival incisions a complete degloving of the m idface up to the nasofrontal angle and the zygoma prominence was possible. All osteotomies could be completed after midfacial degloving. Additional co ronal incisions were not required. Orbitonasal osteotomies for nasal length ening as well as fixation of the medial canthal ligament by a miniplate cou ld be performed under direct vision. There were no postoperative complicati ons such as stenosis of the nasal aperture or disturbances of the mimic mus culature. Midfacial degloving offers good exposure, specially of the centra l part of the midface, without leaving an external scar. It is useful for r econstructive procedures in patients after midface trauma.