Midfacial translocation, a variation of the approach to the rhinopharynx, clivus and upper odontoid process.
OBJECTIVE
A surgical variation of the technique of facial translocation procedure is proposed, which has been called midfacial translocation for approach to the entire medial and lateral region of the middle third of the face, including the rhinopharynx, sphenoid sinus, pterygomaxillary fossa, odontoid process, and clivus.


METHODS
The medical records of five treated patients accordingly were reviewed for an analysis of the surgical technique, the disease, the topography of the lesion, and the complications.


RESULTS
The approach permitted ventral decompression of the bulbomedullary junction with resection of the C1 arch and the odontoid process in four patients and resection of a chordoma of the clivus located along the midline and extending intradurally in the fifth patient. Only one patient presented with dehiscence of the posterior half of the soft palate, this being the only complication observed following surgery in these patients. Three months postoperatively, no patient presented any aesthetic alteration of the face. Functionally, there was only infraorbital hypoaesthesia on the side of flap rotation.


CONCLUSIONS
The technique of midfacial translocation provides both good surgical approach and access to the rhinopharynx, pterygomaxillary fossa, high odontoid process and clivus, with few adverse sequelae for the patient.
de Mello-Filho
Francisco Veríssimo
FV
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil. fdmfilho@fmrp.usp.br
Mamede
Rui Celso Martins
RC
Ricz
Hilton Marcos Alves
HM
Susin
Rafael R
RR
Colli
Benedicto Oscar
BO
D002817:Chordoma / Q000601:surgery; D035301:Cranial Fossa, Middle / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D019299:Decompression, Surgical; D004388:Dura Mater / Q000601:surgery; D005145:Face / Q000601:surgery*; D005147:Facial Bones / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008875:Middle Aged; D009305:Nasopharynx / Q000601:surgery*; D009809:Odontoid Process / Q000601:surgery*; D009915:Orbit / Q000294:innervation; D010160:Palate, Soft / Q000473:pathology; D010985:Platybasia / Q000601:surgery; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery; D013101:Sphenoid Sinus / Q000601:surgery; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000209:etiology