[Several variantes of transfacial approach to calvaria bases and subbasal space].

UNLABELLED: Surgical procedure of transfacial translocation is one of procedures that ensure the best approach and visualization of the whole medial and lateral region of the middle third of the face, base of calvaria and rhinopharynx, sphenoid sinus, pterygomaxillary fossa, odontoid process and clivus.

PATIENT AND

METHODS

In ten patients using transfacial approach, the tumors of base of calvaria and subbasal space were removed. There were six planocellular carcinomas, two transitional carcinomas and two tumors with endocranial origin. We analyzed following parameters; the location of tumor, used surgical procedures, results and complications.

RESULTS

This approach allowed resection of bone part of base of calvaria and subbasal space in middle and lower third of skull. The bone defect was replaced by iliac and parietal bone grafts. There were no cases of graft rejection. In three patient bones defect was repaired with titanium mesh covered by pericranial flap. In one patient necrosis of nasal bone occurred and defect was repaired with titanium mesh. There was no dehiscence of wound either on skin or oral mucosa. Three to five months after operation there were no facial esthetic problems. Functional disturbances were found in two patients with infraorbital hypoaesthesia at the side where flap was rotated.

CONCLUSION

Middle face translocation technique ensure good surgical approach to base of skull and subbasal space with good visualization and comfort with good outcome for patient.