Abstract
Because of a low cure rate, little attention has been paid to facial deformity after surgical treatments of carcinoma of the maxillary sinus. After the Satoh's combined therapy had been adopted, the primary cure rate of the disease has been greatly increased in our clinic. In contrast to Satoh's excellent results of the combined therapy only, however, further surgery, such as total or partial maxillectomy, following the combined therapy has been necessary in the majority of our cases. The situation brought us a necessity to make some efforts to minimize facial deformity after the surgery which is of a great disadvantage to the patients in their social activities.
On the basis of cosmetic assessments in forty postoperative cases, causative and preventive factors of the facial deformity were investigated in the present investigation. The results led us to the following conclusions
1. Total maxillectomy results in a greater deformity than partial maxillectomy.
2. Removal of the inferior, especially the latero-inferior bony wall of the orbit causes a downward displacement of the eye ball and the lower eye lid, which is prevented by producing a support with a septal flap at the floor of the orbit.
3. A retraction of the cheek and an upward displacement of the nasal wing and the corner of the mouth are frequently resulted from maxillectomy. They are prevented to a great extent by skin grafting on the wound of the cheek.
4. After skin grafting, compact packing is essential to keep the face from being deformed. Several pieces of T-P gauze are useful for this purpose until the wound is completely lined with epithelium. Prosthesis should be applied after the wound has been lined.
