Transmaxillary approach to the cranial base: an evaluation of 11 cases.
Surgical access to the skull base is always difficult, especially because of the noble anatomic structures present there. Maxillary osteotomy provides direct view to the clivus region and the neck spine, and it also bears less morbidity when compared to the many other accesses described in the literature.


OBJECTIVE
to assess 11 patients submitted to transmaxillary osteotomy, describing the surgical technique and postoperative results and complications.


METHODS
A retrospective study involving eleven patients submitted to transmaxillary approach to the brainstem. We studied dental occlusion, trans and postoperative bleeding, bone necrosis and soft tissue alterations. All followed the same surgical protocol and were followed up for two years.


RESULTS
after treatment, all the patients improved in their clinical status and had no neurological complication, trans and postoperative hemorrhage or major complications were seen. Among the complications, two patients had incomplete maxilla fracture, two had laceration of their nasal mucosa and one had, as late complication, an oral-sinusal fistula.


CONCLUSIONS
Transmaxillary osteotomy provided proper access to the clivus for brainstem decompression with low rate of complications in this series.
Caubi
Antonio Figueiredo
AF
Specialist and master's degrees in Buccomaxillofacial Surgery and Traumatology / doctoral student in Buccomaxillofacial Surgery and Traumatology, FOP/UPE. Adjunct professor, Faculdade de Odontologia de Pernambuco, FOP/UPE.
Lago
Carlos Augusto Pereira
CAP
Specialist and master's degrees in Buccomaxillofacial Surgery and Traumatology / doctoral student in Buccomaxillofacial Surgery and Traumatology, FOP/UPE. Adjunct professor, Faculdade de Odontologia de Pernambuco, FOP/UPE.
do Egito Vasconcelos
Belmiro Cavalcanti
BC
Specialist, master's and doctoral degrees in Buccomaxillofacial Surgery and Traumatology. Adjunct professor of Buccomaxillofacial Surgery and Traumatology, Faculdade de Odontologia de Pernambuco, FOP/UPE. Coordinator of the master's and doctoral programs in Buccomaxillofacial Surgery and Traumatology, FOP/UPE. Electronic address: belmiro@pesquisador.com.br.
E Oliveira Silva
Emanuel Dias
ED
Specialist in Buccomaxillofacial Surgery and Traumatology, regent of the Buccomaxillofacial Surgery and Traumatology Discipline, FOP/UPE.
Rocha
Nelson Studart
NS
Specialist in Buccomaxillofacial Surgery and Traumatology, buccomaxillofacial surgeon, Hospital Getúlio Vargas - PE.
de Morais
Hécio Henrique Araújo
HHA
Specialist in Buccomaxillofacial Surgery and Traumatology, buccomaxillofacial surgeon, Hospital da Restauração. Faculdade de Odontologia de Pernambuco - FOP/UPE. Buccomaxillofacial Surgery and Traumatology Discipline.
D000293:Adolescent; D000328:Adult; D003388:Cranial Fossa, Posterior / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008437:Maxilla / Q000293:injuries / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods* / Q000592:standards; D011183:Postoperative Complications; D012189:Retrospective Studies; D019291:Skull Base / Q000601:surgery*; D055815:Young Adult