Long-term experiences by using modified facial degloving technique

Introduction: The widely used external approach (Weber-Fergusson's incision) for the removal of maxillo-ethmoidal tumors leaves stigmatizing scars and deformities on the patient's face. As an alternative technique, the scarless facial degloving approach was first described in the 1970's, and since then, several modifications have been developed. Method: We have been using our modified facial degloving technique for eight years now with maxillo-ethmoidal tumors. Between 2012 and 2019, 34 consecutive patients have been operated with our modified facial degloving approach at the Department of Oto-Rhino-Laryngology and Head-Neck Surgery, University of Szeged, Hungary. We describe our method which provides a wide surgical approach via an osteoplastic flap for the whole nasal and paranasal region, with good cosmetic results. Results and conclusion: We have evaluated our results with acoustic rhinometry and photo-documentation of the fa-cial mimic postoperatively. Neither narrowing of the nasal cavity on the operated side (loss of nasal breathing function), nor facial movement dysfunction was visible in our patients. We represent our patients' survival in Kaplan-Meier curve. Although several modifications of the original facial degloving approach have been published, in our technique, the novel osteoplastic flap and the intact soft tissue of the nasal and midfacial region results in shorter hospitalization time and fewer complications. Our modified facial degloving technique offers proper and safe surgical resection for tumors of the maxillo-ethmoid region. It can be routinely combined with endoscopic techniques, and, if necessary, can be converted to an open approach.