[Use of median fronto-naso-orbital flap to decrease the incidence of complications in patients undergoing craniofacial resection].
BACKGROUND
Resection of malignant neoplasms invading the anterior cranial base is performed with craniofacial resection (CFR) with acceptable results in complication rates and oncologic outcomes. However, still there are series with major morbidity in up to 40% of patients, and mortality of 5%. A retrospective study was performed to evaluate the results in terms of morbidity, mortality, function and aesthetics using a median fronto orbital flap (MFOF).


METHODS
The MFOF was used in 28 consecutive patients who presented to the Head and Neck Service from 1992 to 1999, in the Instituto Nacional de Cancerología, Mexico City, and was combined with a superior rhinotomy for en bloc resection of the ethmoid complex in the last 12 cases. 89% of patients had malignant neoplasms.


RESULTS
1 death occurred in this series (3%) and the global morbidity was 35%. Aesthetics and function were good to excellent. Percentages of tumor-free survival for malignant lesions was 76% and 41% at 2 and 5 years follow up, respectively.


CONCLUSIONS
CFR is a safe approach for treatment of neoplasms of the anterior skull base. MFOF mobilization decreases complication rates and gives superb exposure for en bloc resection of tumors invading the ethmoidomaxillary complex specially when combined with a superior rhinotomy. A positive impact on quality of life was obtained.
Carrillo
J F
JF
Departamento de Cabeza y Cuello, División de Cirugía, Instituto Nacional de Cancerología, México, D.F. México. josecarr@df1.telmex.net.mx
Celis
M A
MA
Cano
A M
AM
Barrera
J L
JL
Rivas León
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005004:Ethmoid Bone / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000637:transplantation*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*; D013524:Surgical Flaps