The role of midfacial degloving approach for maxillary cysts and tumors

Kitagawa, Yoshimasa; Baur, Dale; King, Steven; Helman, Joseph I

doi:10.1016/j.joms.2002.09.001

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Volume 61, Issue 12 , Pages 1418-1422, December 2003

The role of midfacial degloving approach for maxillary cysts and tumors

Yoshimasa Kitagawa, DDS, PhD
- Formerly, Visiting Assistant Professor, Section of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA; Currently, Associate Professor, Department of Dentistry and Oral Surgery, Fukui Medical University, Fukui, Japan
Dale Baur, DDS, MD
- Formerly, Head and Neck Fellow, Section of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI; Currently, Chief, Oral and Maxillofacial Surgery Service, and Director, Residency Program, Eisenhower Army Medical Center, Fort Gordon, Augusta, GA, USA
Steven King, DDS
- Formerly, Resident, Section of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI; Currently, Private Practice, Atlanta, GA, USA
Joseph I Helman, DMD
- Chair, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
- Address correspondence and reprint requests to Dr Helman: Section of Oral and Maxillofacial Surgery, University of Michigan Medical Center, 1500 East Medical Dr, Room B1304, Ann Arbor, MI 48109-0018, USA

Abstract

Purpose:

The midfacial degloving approach has been used as a surgical approach to gain access to regions of the midface that would otherwise require external incisions. This article describes the role of this technique for various maxillary lesions.

Patients and Methods:

Thirteen patients underwent the midfacial degloving technique for 8 maxillary benign lesions and 5 malignant lesions. This procedure uses 4 basic incisions: 1) sublabial incision, 2) bilateral intercartilaginous incisions, 3) septocolumellar-complete transfixion incisions, and 4) bilateral piriform aperture incisions extending to the vestibule.

Results:

All patients successfully underwent the planned procedures after the midfacial degloving technique for the treatment of benign or malignant lesions without significant complications. Postoperative sequelae were nasal crusting and infraorbital hypesthesia, both of which resolved.

Conclusions:

The midfacial degloving approach offers good exposure of the mid third of the face with excellent cosmetic results. This approach may be combined with downfracture of the maxilla for access to expose and resect sinonasal malignancies. The midfacial degloving technique is a viable procedure with low morbidity and excellent cosmetic outcomes.