Midfacial degloving surgical approach: experience at Siriraj Hospital

Midfacial degloving surgical approach is an excellent alternative to the lateral rhinotomy in exposure to the nasal cavity, paranasal sinuses and the nasopharynx. By lifting the soft tissue from the midportion of the face, many extensive benign tumors such as inverted papilloma, nasopharyngeal angiofibroma and some limited malignant lesions could be safely removed. This procedure could be combined with other approaches such as transtemporal, intracranial approach to resect more extensive tumors around the orbit, central skull base, as well. This technique was applied in 40 cases, ranging from 12-72 years of age and in a variety of diseases in Siriraj Hospital from 1991 to 2000. Fifty five per cent were diagnosed as inverted papilloma and 20 per cent were nasopharyngeal angiofibroma. The surgical technique in this operation was emphasized and it has proved to be an extensively valuable procedure for wide exposure of the operative field without any external scar. Functional outcome was obtained in most of the cases with minimal complications.