Relationship between bite force, occlusal contact area, and three-dimensional facial soft tissue in dentofacial deformities.

PURPOSE: This study aimed to investigate three-dimensional facial soft tissue dimensions, maximum bite force (MBF), and occlusal contact area in patients with DFD. In addition, we analyzed the relationship between MBF and the three-dimensional facial measurements. METHODS: Thirty-two patients with skeletal Class III DFD and 20 patients with Class II DFD underwent a soft tissue evaluation using surface laser scanning, as well as MBF and occlusal contact area assessments. The DFD groups were compared with each other and with 25 healthy subjects. RESULTS: Significant morphological differences were found in the transversal, vertical, and anteroposterior dimensions between Class II DFD and Class III DFD. Both DFD groups presented an increased linear distance of chin height, which was strongly related with decreased MBF magnitude. The DFD groups exhibited lower MBF and occlusal contact area, with no significant differences between Class II and Class III DFD. CONCLUSION: The presence of DFD affected 3D measurements of facial soft tissue, causing variations beyond normal limits, lower MBF, and occlusal contact area in both Class II and Class III DFD patients. The vertical dimension might have influenced the lower MBF magnitude in the studied skeletal deformities.

Relationship between bite force, occlusal contact area, and three-dimensional facial soft tissue in dentofacial deformities

ABSTRACT Purpose This study aimed to investigate three-dimensional facial soft tissue dimensions, maximum bite force (MBF), and occlusal contact area in patients with DFD. In addition, we analyzed the relationship between MBF and the three-dimensional facial measurements. Methods Thirty-two patients with skeletal Class III DFD and 20 patients with Class II DFD underwent a soft tissue evaluation using surface laser scanning, as well as MBF and occlusal contact area assessments. The DFD groups were compared with each other and with 25 healthy subjects. Results Significant morphological differences were found in the transversal, vertical, and anteroposterior dimensions between Class II DFD and Class III DFD. Both DFD groups presented an increased linear distance of chin height, which was strongly related with decreased MBF magnitude. The DFD groups exhibited lower MBF and occlusal contact area, with no significant differences between Class II and Class III DFD. Conclusion The presence of DFD affected 3D measurements of facial soft tissue, causing variations beyond normal limits, lower MBF, and occlusal contact area in both Class II and Class III DFD patients. The vertical dimension might have influenced the lower MBF magnitude in the studied skeletal deformities.

Two-Stage Treatment of Facial Asymmetry Caused by Unilateral Condylar Hyperplasia

Condylar hyperplasia (CH) is a rare, self-limiting process manifesting between the first and third decades of life. CH causes facial asymmetry and derangement of the occlusion. Management involves resection of the condylar head and orthognathic surgery. This paper describes the case of a 37-year-old woman with spontaneous onset of CH over a span of approximately 25 years. The condition was managed with resection of the condyle alone, which dramatically improved facial asymmetry and altered the occlusion within a few months of follow up. Orthodontic treatment was then carried out and the patient underwent orthognathic surgery after 3 years. The patient is currently satisfied with her appearance and function and there are no signs of recurrence.

Hiperplasia condilar (HC) é um processo raro e auto-limitativo que ocorre entre a 1a e a 3a décadas de vida. Ela causa assimetria facial e alteração da oclusão. O tratamento envolve ressecção da cabeça do côndilo e cirurgia ortognática. Este artigo descreve o caso de uma mulher de 37 anos com início espontâneo de HC e duração de aproximadamente 25 anos. O tratamento foi feito com ressecção apenas do côndilo, o que melhorou consideravelmente a assimetria facial e a oclusão em poucos meses de acompanhamento. Seguiu-se o tratamento ortodôntico e a paciente foi submetida a cirurgia ortognática três anos depois. Atualmente a paciente está satisfeita com sua aparência e função, sem apresentar sinais de recorrência.

Multiple supernumerary teeth in a nonsyndromic 12-year-old female patient - a case report.

Supernumerary teeth (ST) are uncommon alterations of development that may appear in either of the dental arches and that are frequently associated with syndromes such as cleidocranial dysplasia and Gardner syndrome. Multiple ST in individuals with no other disease or syndrome are very rare. In view of this situation, correct diagnosis, treatment and evaluation of ST with the use of appropriate imaging techniques are highly important. This case report presents radiographic images of a nonsyndromic 12-year-old female patient who presented with 14 supernumerary teeth and was treated under general anesthesia, with the extraction of all ST in a single surgical intervention. During the postoperative period, the patient did not complain of pain nor did she present any signs or symptoms of infection. During late follow-up period, due to difficulty in traction of the maxillary right canine and mandibular left first premolar towards the dental arch, it was necessary to extract these teeth under local anesthesia. Radiographic examination 3 years after surgery revealed the absence of ST and of diseases related to the existence of these teeth.

A Cephalometric Analysis for Evaluation of Changes in Soft Tissues in the Regions of the Upper and Lower Lips and Chin due to Orthognathic Maxillary Advancement Surgery

Introduction: There is currently no consensus regarding the best method for predicting the changes in soft tissues due to the modification of hard tissues in orthognathic surgery. Objective: To measure the changes in soft tissues of the upper lip, lower lip, and chin regions due to the modifications of hard tissues caused by orthognathic maxillary advancement surgery using a cephalometric methodology. Methods:  The study was conducted on 35 patients with dentoskeletal and facial deformities submitted to orthognathic maxillary advancement surgery. Two teleradiographs were taken: one during the preoperative period and the other 1 year after the surgery, on which the cephalometric tracing was drawn. Results: A strong correlation (r = 0.747) was demonstrated in the horizontal analysis between the hard A (Ah) point (located in the deepest point of the anterior curvature of the maxilla) and the soft A (As) point in the advancement of the maxilla, with a mean variation of 0.859% occurring in As with each 1% variation of the Ah point. A mean variation of 0.698% occurred in the superior soft prostion point (prolongation of the superior hard prostion point to its corresponding point on soft tissue) for each 1% variation in the superior hard prostion point (bone point located at the junction of the alveolar process with the crown of the upper incisors). Conclusion: The cephalometric methodology applied here revealed that the soft tissues of the upper lip accompanied 70 to 80% of the movement of hard tissues in maxillary advancement and that the soft tissues of the lower lip did not change or showed no significant changes...

Multiple Supernumerary Teeth in a Nonsyndromic 12-Year-Old Female Patient - A Case Report

Supernumerary teeth (ST) are uncommon alterations of development that may appear in either of the dental arches and that are frequently associated with syndromes such as cleidocranial dysplasia and Gardner syndrome. Multiple ST in individuals with no other disease or syndrome are very rare. In view of this situation, correct diagnosis, treatment and evaluation of ST with the use of appropriate imaging techniques are highly important. This case report presents radiographic images of a nonsyndromic 12-year-old female patient who presented with 14 supernumerary teeth and was treated under general anesthesia, with the extraction of all ST in a single surgical intervention. During the postoperative period, the patient did not complain of pain nor did she present any signs or symptoms of infection. During late follow-up period, due to difficulty in traction of the maxillary right canine and mandibular left first premolar towards the dental arch, it was necessary to extract these teeth under local anesthesia. Radiographic examination 3 years after surgery revealed the absence of ST and of diseases related to the existence of these teeth.

Os dentes supranumerários (DS) são alterações de desenvolvimento pouco frequentes, que podem aparecer em qualquer das arcadas dentárias e estão frequentemente associadas a síndromes como a displasia cleidocraniana e síndrome de Gardner. Múltiplos DS em indivíduos com nenhuma outra doença ou síndrome são muito raros. Diante dessa situação, o correto diagnóstico, tratamento e avaliação dos DS com estudo de imagens apropriadas são de significativa importância. No presente relato de caso, os autores apresentam imagens radiográficas de uma paciente não sindrômica de 12 anos de idade, gênero feminino, com 14 dentes supranumerários, em que o tratamento cirúrgico foi instituído sob anestesia geral, com extração de todos os DS em uma única intervenção cirúrgica. Durante o período pós-operatório, a paciente não se queixou de dor, como também não houve quaisquer sinais ou sintomas de infecção. Durante o acompanhamento, devido à dificuldade de tração do canino superior direito e primeiro pré-molar inferior em direção ao arco dental, foi necessário remover estes dentes sob anestesia local. O exame radiográfico de 3 anos após a cirurgia revelou a ausência dos DS e de doenças relacionadas com a existência desses dentes.

Chewing time and chewing strokes in different dentofacial deformities.

PURPOSE: To verify whether the number of chewing strokes and the chewing time are influenced by dentofacial deformities in habitual free mastication. METHODS: Participants were 15 patients with diagnosis of class II dentofacial deformity (GII), 15 with class III (GIII), and 15 healthy control individuals with no deformity (CG). Free habitual mastication of a cornstarch cookie was analyzed, considering the number of chewing strokes and the time needed to complete two mastications. Strokes were counted by considering the opening and closing movements of the mandible. The time needed to consume each bite was determined using a digital chronometer, started after the placement of the food in the oral cavity and stopped when each portion was swallowed. RESULTS: There were no differences between groups regarding both the number of strokes and the chewing time. However, with regards to the number of strokes, CG and GII presented a significant concordance between the first and the second chewing situation, which was not observed in GIII. The analysis of time showed significant concordance between the first and second chewing situation in CG, reasonable concordance in GII, and discordance in GIII. CONCLUSION: Dentofacial deformities do not influence the number of chewing strokes or the chewing time. However, class III individuals do not show uniformity regarding these aspects.

Postura de cabeça nas deformidades dentofaciais classe II e classe III / Head posture in the presence of class II and class III dentofacial deformities

OBJETIVO: este estudo investiga se existe diferença entre grupos com diferentes deformidades dentofaciais (padrão classe II e classe III) e o grupo sem a deformidade em relação à postura de cabeça. MÉTODO: participaram deste estudo, voluntariamente, 25 pacientes (entre 16 e 40 anos). Dez pacientes com diagnóstico de deformidade dentofacial classe II e 15 pacientes com o diagnóstico de classe III esquelética e 15 voluntários sadios, com equivalência em sexo e idade ao grupo de deformidade, formando o grupo controle. Primeiramente foi realizada a inspeção da postura de cabeça. Logo em seguida foi realizada a avaliação postural de cabeça por meio da fotografia postural (fotogrametria). RESULTADOS: não houve diferença significante (p>0,05) entre os grupos em relação à avaliação postural utilizando-se a fotogrametria. Já em relação à avaliação postural pela inspeção clínica, observou-se uma postura anterior de cabeça nos indivíduos com a deformidade dentofacial padrão classe II, comparados ao padrão classe III (p = 0,001) e ao grupo controle (p = 0,001). Foi visto também que o grupo deformidade classe II apresentou um percentual inferior de indivíduos com posição neutra de cabeça comparado ao grupo deformidade classe III (p = 0,008) e ao grupo controle (p = 0,001). CONCLUSÃO: indivíduos com deformidade dentofacial classe II podem apresentar uma anteriorização de cabeça. Não há influência da deformidade no aumento ou na redução do ângulo cabeça-pescoço, analisado por meio da fotogrametria.

PURPOSE: this study investigates whether there is a difference in head posture between groups with different dentofacial deformities (class II and class III) and a group with no deformity. METHOD: 25 volunteers aged from 16 to 40 year old took part in the study. Ten patients had a diagnosis of class II dentofacial deformity, 15 had a diagnosis of class III skeletal deformity, and 15 healthy volunteers matched for sex and age to the group with deformity were used as a control group. Head posture was first checked, followed by evaluation through postural photography (photogrammetry). RESULTS: there was no significant difference (p>0.05) between groups regarding postural evaluation by photogrammetry. However, postural evaluation using clinical inspection, revealed anterior head posture among subjects with class II dentofacial deformity compared to subjects with class III deformity (p = 0.001) and to control group (p = 0.001). The percentage of class II dentofacial deformity subjects with neutral head posture was also lower compared to class III dentofacial deformity (p = 0.008) and to control group (p = 0.001). CONCLUSION: subjects with class II dentofacial deformity may show anteriorization of the head. There is no influence of the deformity on the increase or reduction of the head-neck angle when analyzed by photogrammetry.

Comparison of the area of the pharynx during wakefulness and induced sleep in patients with obstructive sleep apnea (OSA).

UNLABELLED: The study of obstructive sleep apnea (OSA) has received growing attention over the past years since various aspects have not been sufficiently established. AIM: To evaluate, with the use of magnetic resonance imaging (MRI), changes in the area of the pharynx during wakefulness and induced sleep in patients with OSA. MATERIALS AND METHODS: A prospective study of thirty-two patients with a polysomnographic diagnosis of OSA. All patients were submitted to MR imaging in order to obtain high-definition anatomical sagittal sequences during wakefulness and during sleep induced with Propofol. An area was defined on the sagittal plane in the midline of the pharynx. This region was called pharyngeal midplane (PMP) area. RESULTS: A significant difference in PMP area (mm²) was observed between wakefulness and induced sleep in each patient (p < 0.000001). CONCLUSION: The patients with OSA suffer a significant reduction of 75.5 % in the area of the pharynx during induced sleep compared to wakefulness.

Comparação da área da faringe na vigília e durante o sono induzido em pacientes com Síndrome da Apneia Obstrutiva do Sono (SAOS) / Comparison of the area of the pharynx during wakefulness and induced sleep in patients with Obstructive Sleep Apnea (OSA)

O estudo da Síndrome da Apneia Obstrutiva do Sono (SAOS) tem merecido atenção crescente nos últimos anos, uma vez que vários aspectos não foram ainda suficientemente esclarecidos. OBJETIVO: Avaliar, com o uso da Ressonância Magnética (RM), as modificações da área da faringe durante vigília e sono induzido em pacientes portadores de SAOS. MATERIAL E MÉTODOS: Estudo prospectivo de 32 pacientes com diagnóstico polissonográfico de SAOS. Todos foram submetidos à aquisição das Imagens por RM, com sequências sagitais de alta definição anatômica, realizadas inicialmente com o paciente em vigília e durante o sono induzido por Propofol. Uma área foi definida no plano sagital na linha média da faringe. Essa região passou a ser denominada como área do plano mediano da faringe (PMF). RESULTADOS: As medidas (mm²) da área do PMF de cada paciente, na vigília e durante o sono induzido, apresentaram diferença estatisticamente significante p< 0,000001. CONCLUSÕES: Os pacientes portadores de SAOS sofrem uma significativa redução de 75,5 por cento da área da faringe durante o sono induzido quando comparado à vigília.

The study of obstructive sleep apnea (OSA) has received growing attention over the past years since various aspects have not been sufficiently established. AIM: To evaluate, with the use of magnetic resonance imaging (MRI), changes in the area of the pharynx during wakefulness and induced sleep in patients with OSA. MATERIALS AND METHODS: A prospective study of thirty-two patients with a polysomnographic diagnosis of OSA. All patients were submitted to MR imaging in order to obtain high-definition anatomical sagittal sequences during wakefulness and during sleep induced with Propofol. An area was defined on the sagittal plane in the midline of the pharynx. This region was called pharyngeal midplane (PMP) area. RESULTS: A significant difference in PMP area (mm²) was observed between wakefulness and induced sleep in each patient (p < 0.000001). CONCLUSION: The patients with OSA suffer a significant reduction of 75,5 percent in the area of the pharynx during induced sleep compared to wakefulness.

Chewing time and chewing strokes in different dentofacial deformities / Tempo e golpes mastigatórios nas diferentes deformidades dentofaciais

PURPOSE: To verify whether the number of chewing strokes and the chewing time are influenced by dentofacial deformities in habitual free mastication. METHODS: Participants were 15 patients with diagnosis of class II dentofacial deformity (GII), 15 with class III (GIII), and 15 healthy control individuals with no deformity (CG). Free habitual mastication of a cornstarch cookie was analyzed, considering the number of chewing strokes and the time needed to complete two mastications. Strokes were counted by considering the opening and closing movements of the mandible. The time needed to consume each bite was determined using a digital chronometer, started after the placement of the food in the oral cavity and stopped when each portion was swallowed. RESULTS: There were no differences between groups regarding both the number of strokes and the chewing time. However, with regards to the number of strokes, CG and GII presented a significant concordance between the first and the second chewing situation, which was not observed in GIII. The analysis of time showed significant concordance between the first and second chewing situation in CG, reasonable concordance in GII, and discordance in GIII. CONCLUSION: Dentofacial deformities do not influence the number of chewing strokes or the chewing time. However, class III individuals do not show uniformity regarding these aspects.

OBJETIVO: Verificar se o número de golpes e o tempo mastigatório são influenciados pela deformidade dentofacial, na mastigação habitual livre. MÉTODOS: Participaram 15 pacientes com deformidade dentofacial classe II (GII), 15 com classe III (GIII) e 15 indivíduos sem a deformidade (GC). Foi analisada a mastigação habitual livre de um biscoito de maisena, considerando o tempo e o número de golpes mastigatórios apresentados durante duas mastigações. A contagem dos golpes foi feita considerando os movimentos mandibulares de abertura e fechamento da mandíbula. O tempo para o consumo de cada mordida do alimento foi investigado por meio de um cronômetro digital, acionado após a colocação do alimento na cavidade oral e paralisado no momento da deglutição final de cada porção. RESULTADOS: Não houve diferenças entre os grupos, tanto para a variável referente ao número de golpes, quanto para a relacionada ao tempo. Entretanto, quanto ao número de golpes, observou-se que os grupos GC e GII apresentaram uma concordância significativa entre a primeira e a segunda situação de mastigação, o que não ocorreu com o GIII. Na análise do tempo, houve uma concordância significativa no GC entre a primeira e a segunda situação de mastigação; o GII apresentou uma concordância razoável entre as duas situações de mastigação e o GIII apresentou discordância entre as duas mastigações. CONCLUSÃO: As deformidades dentofaciais não influenciam no número de golpes mastigatórios e no tempo da mastigação. Entretanto, os indivíduos classe III não apresentam uma uniformidade nesses aspectos.

Inclinação de cabeça durante a mastigação habitual nas deformidades dentofaciais classe II e III / Head inclination during habitual chewing in the presence of class II and III dentofacial deformities

OBJETIVO: este estudo investiga a diferença entre grupos com deformidade dentofacial (padrão classe II e classe III), em relação à preferência mastigatória referida e inclinação de cabeça durante a mastigação, assim como predomínio intra-grupo de cada um desses aspectos, comparativamente a um grupo controle. MÉTODOS: participaram deste estudo, voluntariamente, 25 pacientes (entre 18 e 35 anos). Doze pacientes com diagnóstico de deformidade dentofacial classe II e 13 pacientes com o diagnóstico de classe III esquelética e 10 voluntários, com equivalência em sexo e idade ao grupo de deformidade, formando o grupo controle. Os voluntários da pesquisa foram questionados sobre a existência de um lado de preferência mastigatória. Em seguida foram filmados durante a mastigação habitual de um biscoito maizena e através das imagens captadas, a postura de cabeça pôde ser analisada. RESULTADOS: não houve diferença entre os grupos em relação à preferência mastigatória referida, entretanto os grupos com deformidades dentofaciais apresentaram predomínio significativo de preferência mastigatória referida. Os grupos com deformidade dentofacial apresentaram maior predomínio de inclinação de cabeça durante a mastigação quando comparados ao grupo controle. CONCLUSÃO: indivíduos com deformidade dentofacial podem apresentar uma preferência mastigatória e alteração de postura de cabeça durante a mastigação.

PURPOSE: the study was conducted in order to investigate the difference among groups with class II and class III dentofacial deformities regarding reported chewing side preference and head inclination during chewing and to determine the intra-group predominance for these features when compared to a control group. METHODS: twenty-five volunteers aged from 15 to 34 years took part in the study, 12 of them with a diagnosis of class II dentofacial deformity, 13 with class III dentofacial deformity, and 10 control volunteers aged from 18 to 32 years matched for sex and age to the groups with deformity. The subjects were questioned on the presence of a chewing side preference and were recorded during habitual chewing of a cornstarch cookie for analyzing head posture through the images. RESULTS: there was no difference among the groups regarding reported chewing side preference, although the groups with dentofacial deformities had a significant predominance of reported chewing side preference. The groups with dentofacial deformities showed a greater predominance of head inclination during chewing when compared to the control. CONCLUSION: individuals with dentofacial deformities may show a chewing side preference and changes in head posture during chewing.

Traqueostomia / Tracheostomy

Traqueostomia consiste na abertura da parede anterior da traqueia comunicando-a com o meio externo.Está indicada em situações onde existe obstrução da via aérea alta, acúmulo de secreção traqueal,debilidade da musculatura respiratória e intubação traqueal prolongada. Ou seja, a indicação ocorre em situações em que a dificuldade respiratória não possa ser revertida em curto espaço de tempo.

Tracheostomy consists in creating an opening in the anterior aspect of the cervical trachea, communicatingthe tracheal lumen with external environment. It is recommended in cases of upper airway obstruction,prolonged orotracheal intubation, respiratory muscles weakness and mandatory secretion removal.In general, tracheostomy is performed in situations of respiratory distress that cannot be resolved in a short time.

Osteotomia de Le Fort I no tratamento do angiofibroma juvenil: aspectos da técnica cirúrgica / Le Fort I osteotomy on juvenile angiofibroma treatment: surgical-technical aspects

O angiofibroma juvenil (AJ) é um tumor benigno, que ocorre comumente na região da nasofaringe de indivíduos jovens gênero masculino. As técnicas cirúrgicas mais empregadas para ressecção do angiofibroma são a rinotomia lateral, a abordagem transpalatina, a via endoscópica e o Le Fort I. A osteotomia do tipo Le Fort I foi introduzida para correção de deformidades esqueléticas do terço médio da face, sendo eventualmente utilizada no tratamento de tumores da cavidade nasal, nasofaringe e base de crânio. A proposta deste estudo é revisar a técnica da osteotomia tipo Le Fort I na abordagem do AJ e apresentar modificações, que auxiliam na sua execução e no controle das recidivas locais e das complicações cirúrgicas.

Juvenile angiofibroma (JA) is a benign nasopharyngeal tumor that occurs in adolescent male patients. The most known surgical techniques for resection of JA are lateral rhynotomy, transpalatal, endoscopic and Le Fort I approaches. The Le Fort I osteotomy was popularized for the correction of skeletal deformities of the mid-face and sometimes for the treatment of tumors of the nasal cavity, nasopharynx and skull base. The purpose of this study is to review the Le Fort I osteotomy technique used in juvenile angiofibroma approach and present some changes that help the performing and diminish the recurrence and surgical complications.

Tratamento da síndrome da apnéia-hipopnéia obstrutiva do sono (SAHOS) com avanço maxilomandibular: relato de dois casos / Treatment of obstructive sleep apnea syndrome (OSAS) with maxillomandibular advancement: two cases report

A Síndrome da Apnéia-Hipopnéia Obstrutiva do Sono é uma doença crônica, evolutiva, com graves repercussões sistêmicas. Alguns fatores predisponentes foram identificados, como obesidade, variações no tônus muscular, alterações anatômicas esqueléticas da face e dos tecidos moles que circundam a faringe. Procedimentos cirúrgicos visando a aumentar o espaço aéreo têm sido utilizados no tratamento da Síndrome da Apnéia-Hipopnéia Obstrutiva do Sono. A cirurgia esquelética de avanço maxilomandibular tem sido indicada em casos graves de Síndrome da Apnéia-Hipopnéia Obstrutiva do Sono, isoladamente ou combinada com procedimentos cirúrgicos complementares. Apresentamos dois casos graves de Síndrome da Apnéia-Hipopnéia Obstrutiva do Sono, tratados com cirurgia esquelética de avanço maxilomandibular, que evoluíram com melhora dos sintomas clínicos da doença e com acentuada diminuição do índice de apnéia hipopnéia.

Obstructive Sleep Apnea Syndrome (OSAS) is an evolving chronic disease with severe systemic consequences. Some procatartic factors have been identified, such as obesity, variations in muscular tonus, and facial skeletal anatomic changes, as well as changes in the soft tissues that circle the larynx. Surgical processes have been used in the treatment of OSAS. Surgery of maxillomandibular advancement has been recommended in severe cases of OSAS, alone or together with complementary surgical proceedings. The authors present two severe cases of OSAS treated with maxillomandibular advancement evoluting with improvement of clinical symptoms and significant reduction of Apnea/Hypopnea Index (AHI).

Índice de complicações na translocação médio-facial para o acesso à base do crânio: análise de 12 casos

Objetivo: Propor uma alternativa cirúrgica ao acesso do terço médio da face incluindo a rinofaringe, seio esfenoidal, fossa pterigopalatina, processo odontóide e clivus. Expor como a técnica apresentada oferece exposição ampla da região e mínimas complicações que são avaliadas neste trabalho. Método: Os registros médicos de doze pacientes submetidos a translocação médio-facial no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP, de 1995 a 2008, foram analisados quanto a doença tratada, localização das lesões, técnica cirúrgica e complicações. Resultados: Seis pacientes eram portadores de cordoma do clivus, neste grupo três pacientes não apresentaram complicações, um desenvolveu ectrópio, um apresentou hipoestesia do nervo infra-orbitário e um evoluiu com insuficiência velo-palatina leve. Um paciente com diagnóstico de estesioneuroblastoma apresentou granulama nasal. Os outros cinco pacientes tinham compressão vértebro-basilar e, no pós-operatório, três deles não apresentaram complicações. Dentre os que apresentaram complicações, um evoluiu com deiscência parcial do palato mole e outro apresentou pequenos granulomas em uma cavidade nasal, paresia do ramo oftálmico e leve insuficiência velo-palatina. Conclusão: A técnica de translocação médio-facial fornece uma ampla abordagem à base do crânio com poucas seqüelas e de baixa morbidade para o paciente no pós-operatório.