ABSTRACT
BACKGROUND: Fibrous dysplasia (FD) is a benign bone lesion characterized by the progressive replacement of normal bone with fibro-osseous connective tissue. The maxilla is the most commonly affected area of facial bone, resulting in facial asymmetry and functional disorders. Surgery is an effective management option and involves removing the diseased bone via an intraoral approach: conservative bone shaving or radical excision and reconstruction. CASE PRESENTATION: This case report describes a monostotic fibrous dysplasia in which the patient’s right midface had a prominent appearance. The asymmetric maxillary area was surgically recontoured via the midfacial degloving approach under general anesthesia. Follow-up photography and radiographic imaging after surgery showed the structures were in a stable state without recurrence of the FD lesion. Furthermore, there were no visible scars or functional disability, and the patient reported no postoperative discomfort. CONCLUSIONS: In conclusion, the midfacial degloving approach for treatment of maxillary fibrous dysplasia is a reliable and successful treatment option. Without visible scars and virtually free of postoperative functional disability, this approach offers good exposure of the middle third of the face for treatment of maxillary fibrous dysplasia with excellent cosmetic outcomes.
Subject(s)
Humans , Anesthesia, General , Cicatrix , Connective Tissue , Facial Asymmetry , Facial Bones , Fibrous Dysplasia, Monostotic , Follow-Up Studies , Maxilla , Photography , RecurrenceABSTRACT
In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.
Subject(s)
Humans , Cicatrix , Congenital Abnormalities , Epistaxis , Fractures, Bone , Nasal Cavity , Nasopharynx , Paresthesia , Rhinoplasty , Ribs , Surgery, Plastic , TransplantsABSTRACT
Subject(s)
Child , Female , Humans , Cicatrix , Maxillary Sinus , Nasal Cavity , Nasopharynx , Paranasal Sinuses , Skull BaseABSTRACT
Traditionally, surgical access to the midface structures for the removal of benign or malignant tumors has been through paranasal sinuses, external facial incisions, or hard palate. However, large or malignant lesions of the nose, paranasal sinuses and nasopharynx have a particularly difficult problem of these surgical approach. The midfacial degloving approach combined with/without medial maxillectomy provide an alternative method that requires no facial incisions and minimal functional impairment. Exposure and surgical facility may be equal or superior to that of traditional procedures in selected cases. Combining this method with bi-frontal, brow, transtemporal, and transpalatal approach is also possible for extensive lesions. We did midfacial degloving in 13 patients who were seen with benign or malignant lesions involving the midface structures from Jan. 1991 to Dec. 1994. Thus we analysed the clinical data including the advantage and complications of this method retrospectively.
Subject(s)
Humans , Nasopharynx , Nose , Palate, Hard , Paranasal Sinuses , Retrospective StudiesABSTRACT
Ameloblastoma is a histologically benign tumour originating from epithelial components of the embryonic tooth, arrested developmentally prior to enamel formation. Clinically this tumour is locally invasive, potentially lethal and occasionally shows malignant features with systemic metastases. The maxilla is by far less frequently affected than the mandible. We have experienced a case of multicystic ameloblastoma originating from right maxilla. The patient was 39-year-old male who complained pain and numbness on right cheek. The patient was treated with subtotal maxillectomy by midfacial degloving approach. The final histopathologic diagnosis was a acanthomatous ameloblastoma.