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[How I do it - total maxillectomy via midfacial degloving]
M Westhofen1, W Mautsch, M Blaum
1Klinik für Hals-, Nasen-, Ohrenheilkunde und Plastische Kopf- und Halschirurgie des Universitätsklinikums der RWTH Aachen, Germany. mwesthofen@post.klinikum.rwth-aachen.de
Laryngo- Rhino- Otologie
|September 14, 2001
Summary
Midfacial degloving offers a viable surgical approach for total maxillectomy in treating maxillary sinus adamantinoma. This technique facilitates functional and aesthetic restoration for patients with this rare tumor.
Area of Science:
- Oral and Maxillofacial Surgery
- Head and Neck Oncology
- Pathology
Background:
- Adamantinoma is a rare odontogenic tumor originating in the jaw.
- Maxillary sinus adamantinomas require aggressive surgical management.
- Midfacial degloving is a surgical approach providing wide exposure of the midface.
Observation:
- A case report of a 67-year-old male with maxillary sinus adamantinoma (solid and multicystic plexiform differentiation) is presented.
- This is the first report detailing the surgical treatment of adamantinoma using the midfacial degloving technique.
- Preoperative computed tomography (CT) staging was crucial for assessing tumor extent and planning resection.
Findings:
- Midfacial degloving allowed for complete maxillectomy in this case.
- The surgical approach enabled complete functional restoration of speech and swallowing.
- Postoperative obturation, managed through interdisciplinary dental and ENT collaboration, was essential for oral rehabilitation.
Implications:
- Midfacial degloving is a recommended surgical option for maxillary tumors, including those requiring total maxillectomy, provided there is no invasion of cheek muscles or upper lip.
- Accurate preoperative staging via CT is vital for surgical planning and determining the extent of maxillectomy.
- Interdisciplinary management is key for successful functional and aesthetic outcomes following extensive maxillary resection.
