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Chapter-017 Midfacial Degloving Approach to the Nose, Sinuses, and Skull Base

BOOK TITLE: Head & Neck Surgery (2 Volumes)

Author
1. Har-El Gady
2. Zeitler Daniel M
ISBN
9788184486797
DOI
10.5005/jp/books/10351_17
Edition
1/e
Publishing Year
2009
Pages
8
Author Affiliations
1. SUNY-Downstate Medical Center, New York, USA, Lenox Hill Hospital, New York, New York, USA, State University of New York, Downstate Medical Center, Brooklyn, New York, USA
2. New York University School of Medicine, New Bellevue Hospital, New York, USA
Chapter keywords
midfacial degloving approach, MFD, nose, sinuses, skull base, malignant neoplasms, odontogenic lesions, vascular lesions, massive midfacial trauma, sphenopalatine artery, malignant tumors, anterior skull base, ethmoidectomy

Abstract

This chapter discusses midfacial degloving approach to the nose, sinuses, and skull base, where midfacial degloving approach (MFD) does not require any external facial incisions. The MFD approach is used to manage different benign and malignant neoplasms, odontogenic lesions, vascular lesions, massive midfacial trauma, and penetrating trauma. One of the most common procedures we performed through MFD is medial maxillectomy with ethmoidectomy, where the procedure of medial maxillectomy is begun with removing the anterior wall of the maxillary sinus while preserving and protecting the infraorbital neurovascular bundle. Before starting the resection itself, the nasolacrimal sac or duct system (NLS) needs to be addressed. The specimen is removed quickly and the bleeding sphenopalatine artery is clamped and ligated. The MFD approach can be also used for anterior craniofacial resection for benign or malignant tumors of the anterior skull base.

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