Midfacial degloving approach to the nose, sinuses, and skull base

Thirty-seven patients with a variety of neoplastic, vascular and traumatic lesions of the midfacial skeleton, orbits, and central compartment of the anterior and middle cranial fossae were managed surgically via the midfacial degloving approach. Excellent exposure was achieved in all patients. Complete removal of the lesion was achieved in all patients with neoplastic disease. Successful repair of the defect was achieved in all patients with traumatic injuries. The most common complication related to midfacial degloving was temporary infraorbital anesthesia or hypesthesia. Only one patient developed symptomatic nasal valve stenosis. Midfacial degloving has important advantages over other procedures, especially in cases where bilateral surgery is required or when the avoidance of midfacial incisions and scars is important. In the subgroup of inverted papilloma, midfacial degloving is currently our procedure of choice for en-block medial maxillectomy and ethmoidectomy.