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Modified midfacial translocation for access to ventral skull base tumours

Published online by Cambridge University Press:  29 August 2014

A Hussain ,
M Shakeel ,
V Vallamkondu  and
M Kamel
A Hussain*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, University of Aberdeen, Scotland, UK
M Shakeel
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, University of Aberdeen, Scotland, UK
V Vallamkondu
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, University of Aberdeen, Scotland, UK
M Kamel
Affiliation:
Department of Neurosurgery, University of Aberdeen, Scotland, UK
*
Address for correspondence: Mr A Hussain, Ward 45, ENT Dept, Aberdeen Royal Infirmary, Foresterhill Rd, Aberdeen AB25 2ZN, Scotland, UK Fax: 0044 (0)1224 554 569 E-mail: [email protected]
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Abstract

Objective:

To describe our technical modifications of midfacial translocation for access to the nasopharynx, and anterior, central and lateral skull base.

Design:

Retrospective chart review of a prospective case series.

Setting:

Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, Scotland, UK.

Methods:

Along with demographics, other parameters studied were adequacy of exposure, completeness of resection, aesthetic outcome and complications. Our main outcome measures included adequacy of exposure, partial or total resection of tumour, aesthetic outcome, and complications related to surgical technique.

Results:

A total of 48 patients underwent modified midfacial translocation at our institution for nasopharyngeal, parapharyngeal, and anterior, central and lateral skull base tumours. In all cases, the exposure was deemed to be adequate. Two patients developed wound dehiscence in previously irradiated fields. Other incisions healed very well and the aesthetic outcome was regarded as satisfactory.

Conclusion:

Modified midfacial translocation is based on the principle of temporary craniofacial disassembly for access to the skull base. Our modifications offer adequate access and a better aesthetic outcome. All incisions are placed through the aesthetic sub units of the nose with preservation of the lip. Preservation of the bony piriform aperture prevents airway compromise.

Keywords

Base Of SkullFacial TranslocationSurgical ApproachEsthetic Outcome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 9 , September 2014 , pp. 803 - 809
Copyright
Copyright © JLO (1984) Limited 2014 

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Footnotes

Presented at the 64th Annual Meeting of the Canadian Society of Otolaryngology-Head and Neck Surgery, 23–25 May 2010, Niagara Falls, Ontario, Canada.

References

1Hussain, A, Hilmi, OJ, Murray, DP. Lateral rhinotomy through nasal aesthetic subunits. Improved cosmetic outcome. J Laryngol Otol 2002;116:703–6CrossRefGoogle ScholarPubMed
2Janecka, IP, Sen, CN, Sekhar, LN, Arriaga, M. Facial translocation: a new approach to the cranial base. Otolaryngol Head Neck Surg 1990;103:413–19Google Scholar
3Janecka, IP. Classification of facial translocation approach to the skull base. Otolaryngol Head Neck Surg 1995;112:579–85Google ScholarPubMed
4Hao, SP. Modified facial translocation technique to prevent necrosis of bone graft. Laryngoscope 2002;112:1691–5Google Scholar
5Suárez, C, Llorente, JL, Muñoz, C, García, LA, Rodrigo, JP. Facial translocation approach in the management of central skull base and infratemporal tumors. Laryngoscope 2004;114:1047–51Google Scholar
6Hao, SP, Pan, WL, Chang, CN, Hsu, YS. The use of the facial translocation technique in the management of tumors of the paranasal sinuses and skull base. Otolaryngol Head Neck Surg 2003;128:571–5CrossRefGoogle ScholarPubMed
7de Mello-Filho, FV, Mamede, RC, Ricz, HM, Susi, RR, Colli, BO. Midfacial translocation, a variation of the approach to the rhinopharynx, clivus and upper odontoid process. J Craniomaxillofac Surg 2006;34:400–4CrossRefGoogle Scholar
8Krause, GE, Jafek, BW. A modification of the midface degloving technique. Laryngoscope 1999;109:1781–4CrossRefGoogle ScholarPubMed