The application of cranofacial osteotomies to surgical exposure of crantofacial tumors.

Koh, Kyung Suck; Hong, Yoon Gi; Yoon, Kun Chul; Kim, Chang Jin; Kim, Sang Yoon

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1998;25(4):633-643.
Published online June 1, 1998.

The application of cranofacial osteotomies to surgical exposure of crantofacial tumors.

Kyung Suck Koh, Yoon Gi Hong, Kun Chul Yoon, Chang Jin Kim, Sang Yoon Kim

Abstract

Access to the craniofacial skeleton and skull base requires osteotomies. An adequate exposure of neoplasms occupying the skull base and the oral cavity and oropharynx, especially retromolar trigone, is very important for precise tumor ablation. The demonstration by Tessier of the capacity for large segments of bone to survive removal and replacement has enabled skull base tumor surgery to grow into a subspeciality. Through the refined craniofacial exposure osteotomies, the surgery is safer, the operation shorter, and the result better both oncologically and reconstructively. We experienced 24 cases of exposure osteotomies consisting of 12 cases transzygomatic approaches, 1 case tranglabellar osteotomy, 1 case lateral transmaxillary approach, 1 case Le Fort II & midline splitting, and 9 cases mandibulotomy. There was no significant complication except a local wound infection in transzygomatic approach and one case of minimal malocclusion after parasymphyseal mandibulotomy. The orthotopic bone graft and the rigid fixation enables the postoperative morbidity to decrease. It seems that the previously inaccessible craniofacial tumors can be treated through the various exposure osteotomies.