SKULL BASE SURGERY USING THE DEGLOVING TECHNIQUE AN APPROACH WITHOUT FACIAL SCARRING

KUNIO NISHIKAWA; SHINJI NISHIOKA; KATSUYA AOJI; SATOSHI KOIKE; HIDEO NAMEKI

doi:10.3950/jibiinkoka.96.1447

SKULL BASE SURGERY USING THE DEGLOVING TECHNIQUE

AN APPROACH WITHOUT FACIAL SCARRING

KUNIO NISHIKAWA, SHINJI NISHIOKA, KATSUYA AOJI, SATOSHI KOIKE, HIDEO NAMEKI

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Keywords: degloving technique

JOURNAL FREE ACCESS

1993 Volume 96 Issue 9 Pages 1447-1456,1575

DOI https://doi.org/10.3950/jibiinkoka.96.1447

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Published: September 20, 1993 Received: February 24, 1993 Available on J-STAGE: March 19, 2009 Accepted: May 13, 1993 Advance online publication: - Revised: -
Correction information
Date of correction: March 19, 2009 Reason for correction: - Correction: ABSTRACT Details: Wrong : Skull base surgery has been performed in 16 cases for en bloc resection of the nasal cavity and paranasal sinus carcinoma invading the anterior and middle skull base in our department.
The surgical approach to skull base surgery is mainly a combined craniofacial approach, which includes craniotomy via a coronal incision intracranially and a transfacial or transoral approach extracranially.
The direct transfacial approaches, such as lateral rhinotomy, Weber-Furguson incision, and midfacial split, resultin facial scarring. The midface degloving procedure was reported by Casson in 1974. This method can expose the midfacial skeleton by lifting the soft tissue from the face through an intraoral approach without external scarring.
The authors have modified Casson's facial degloving technique and applied it to skull base surgery. The entire cranium and facial skeleton can be extensively degloved by using coronal, gingival and conjunctival incisions.
Then, en bloc resection of the craniofacial compound segment can be accomplished through this degloving approach without external scarring of the face in anterior and middle skull base surgery.
The authors have performed this procedure in 2 cases, and proved it to be an extremely valuable technique, displaying excellent cosmetic and functional results with minimal complications.
Right : Skull base surgery has been performed in 16 cases for en bloc resection of the nasal cavity and paranasal sinus carcinoma invading the anterior and middle skull base in our department.
The surgical approach to skull base surgery is mainly a combined craniofacial approach, which includes craniotomy via a coronal incision intracranially and a transfacial or transoral approach extracranially.
The direct transfacial approaches, such as lateral rhinotomy, Weber-Furguson incision, and midfacial split, resultin facial scarring. The midface degloving procedure was reported by Casson in 1974. This method can expose the midfacial skeleton by lifting the soft tissue from the face through an intraoral approach without external scarring.
The authors have modified Casson's facial degloving technique and applied it to skull base surgery. The entire cranium and facial skeleton can be extensively degloved by using coronal, gingival and conjunctival incisions.
Then, en bloc resection of the craniofacial compound segment can be accomplished through this degloving approach without external scarring of the face in anterior and middle skull base surgery.
The authors have performed this procedure in 2 cases, and proved it to be an extremely valuable technique, displaying excellent cosmetic and functional results with minimal complications.

Date of correction: March 19, 2009 Reason for correction: - Correction: DTPUB Details: Right : 19930920

Date of correction: March 19, 2009 Reason for correction: - Correction: CITATION Details: Wrong : 4) Converse JM, McCarthy JG, Wood-Smith D et al: Principle of craniofacial surgery. Reconstructive Plastic Surgery (2nd Ed.). WB Saunders, Philadelphia, 1977, pp 2427-2492.
5) Casson PR, Bonanno PC, Converse JM et al: The midface degloving procedure. Plast Reconst Surg 53: 102-103, 1974.
6) Prince JC: The midfacial degloving approach to the central skull base. Ear Nose and Throat J 65: 46-53, 1986.
9) Janecka IP, Nuss DW, Sen ChN: Midfacial split for access to the central base. Acta Neurochirurgica Suppl 53: 199-203, 1991.
10) Tessier P: The conjunctival approach to the orbital floor and maxilla in congenital malformation and trauma. J Maxillo-facial Surg 1: 3, 1973.
11) Robert AG, Alan ML, Norman SM et al: The transconjunctival approch to the orbital floor and orbital fat. Ophthal Plastic and Reconst Surg 6: 241-246, 1990.

Right : 4) Converse JM, McCarthy JG, Wood-Smith D: Principle of craniofacial surgery. Reconstructive Plastic Surgery (2nd Ed.). WB Saunders, Philadelphia, 1977, pp2427-2492.
5) Casson PR, Bonanno PC, Converse JM: The midface degloving procedure. Plast Reconst Surg 53: 102-103, 1974.
6) Prince JC: The midfacial degloving approach to the central skull base. Ear Nose and Throat J 65: 46-53, 1986.
9) Janecka IP, Nuss DW, Sen ChN: Midfacial split for access to the central base. Acta Neurochirurgica Suppl 53: 199-203, 1991.
10) Tessier P: The conjunctival approach to the orbital floor and maxilla in congenital malformation and trauma. J Maxillo-facial Surg 1: 3, 1973.
11) Robert AG, Alan ML, Norman SM: The transconjunctival approch to the orbital floor and orbital fat. Ophthal Plastic and Reconst Surg 6: 241-246, 1990.

Date of correction: March 19, 2009 Reason for correction: - Correction: PDF FILE Details: -

Abstract

Skull base surgery has been performed in 16 cases for en bloc resection of the nasal cavity and paranasal sinus carcinoma invading the anterior and middle skull base in our department.
The surgical approach to skull base surgery is mainly a combined craniofacial approach, which includes craniotomy via a coronal incision intracranially and a transfacial or transoral approach extracranially.
The direct transfacial approaches, such as lateral rhinotomy, Weber-Furguson incision, and midfacial split, resultin facial scarring. The midface degloving procedure was reported by Casson in 1974. This method can expose the midfacial skeleton by lifting the soft tissue from the face through an intraoral approach without external scarring.
The authors have modified Casson's facial degloving technique and applied it to skull base surgery. The entire cranium and facial skeleton can be extensively degloved by using coronal, gingival and conjunctival incisions.
Then, en bloc resection of the craniofacial compound segment can be accomplished through this degloving approach without external scarring of the face in anterior and middle skull base surgery.
The authors have performed this procedure in 2 cases, and proved it to be an extremely valuable technique, displaying excellent cosmetic and functional results with minimal complications.

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Correction information

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