Hemifacial Degloving Approach for Medial Maxillectomy: A Modification of Midfacial Degloving Approach

INTRODUCTION Common surgical approaches for medial maxillectomy include lateral rhinotomy and midfacial degloving. Lateral rhinotomy provides an excellent surgical exposure but leaves a prominent scar on the face. Midfacial degloving has been preferred to lateral rhinotomy because it does not leave any external scars on the face, although midfacial degloving has its own limitations. For example, vestibular stenosis is a significant complication that can occur, and the bilateral exposure of the midface may be unnecessary in medial maxillectomy for most unilateral lesions. Several modifications of midfacial degloving have been reported in an attempt to avoid vestibular stenosis. We have designed another modification of midfacial degloving to avoid unnecessary exposure of the healthy side of the midface, as well as vestibular stenosis. The procedure involves a gingivobuccal incision across the midline, a septal transfixion incision, a pyriform aperture incision, and a lateral osteotomy along the frontal process of the maxilla to the nasion. We termed our modification the hemifacial degloving approach. We have performed 12 cases of medial maxillectomy using this hemifacial degloving approach. We present the procedures and the results.