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Utility of the Midface Degloving Approach for Extended Exposure in Maxillary Pathologies

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Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Introduction

A generous exposure of the midface region is essential for a comprehensive and thorough execution of midface surgical procedures, especially bilateral procedures. Traditional approaches to the midface the midface like the lateral rhinotomy and Weber–Fergusson/Dieffenbach incision with their modifications leave a visible scar, and they are limited in their unilateral exposure. The midface degloving approach with its exclusive intranasal and intraoral incisions leaves no external scars and lends excellent bilateral exposure of the maxilla, zygoma, paranasal areas and infraorbital margins from one side to the other. The midface degloving approach is mainly used to expose pathologies of the maxilla, nasal cavities, paranasal sinuses, nasopharynx, and the central compartment of the anterior and middle cranial base. This approach can also be used to treat midface trauma and perform high-level osteotomies.

Materials and Methods

We describe the midface degloving procedure for nine cases operated in the Department of Oral and Maxillofacial Surgery over a period of 7 years (2012–2018): seven maxillary tumors and two maxillary cysts.

Results

We obtained excellent exposure for all the cases using this approach. Complications included mild distortion of the lower lateral nasal cartilages and oro-nasal communication.

Conclusion

The midface degloving approach lends excellent surgical access to the midfacial skeleton including the maxilla, the paranasal areas, the maxillary sinus, the zygoma, and infraorbital rims. The advantages of this approach besides its generous exposure, is the excellent cosmesis it provides leaving no external scars.

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Acknowledgements

Line diagrams: courtesy of Dr Vidya Devi, MDS (OMFS). E-mail: vidya.devi.vuyyuru@gmail.com.

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and General Hospital, Meenakshi Academy of Higher Education and Research (Deemed to be University), Alapakkam Main Road, Maduravoyal, Chennai, 600095, India

    Thomas Zachariah & R. S. Neelakandan

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  1. Thomas Zachariah
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  2. R. S. Neelakandan
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Correspondence to Thomas Zachariah.

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The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from the individual participant included in the study. Additional informed consent was obtained from the individual participant for whom identifying information is included in this article.

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Zachariah, T., Neelakandan, R.S. Utility of the Midface Degloving Approach for Extended Exposure in Maxillary Pathologies. J. Maxillofac. Oral Surg. 19, 217–224 (2020). https://doi.org/10.1007/s12663-019-01287-w

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  • DOI: https://doi.org/10.1007/s12663-019-01287-w

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