Infraorbital nerve transposition to expand the endoscopic transnasal maxillectomy.
The infraorbital nerve (ION) is a terminal branch of the maxillary nerve (V2) providing sensory innervation to the malar skin. It is sometimes necessary to sacrifice the ION and its branches to obtain adequate maxillary sinus exposure for radical resection of sinonasal tumors. Consequently, patients suffer temporary or permanent paresthesia, hypoestesthia, and neuralgia of the face. We describe an innovative technique used for preservation of the ION while removing the anterior, superior, and lateral walls of the maxillary sinus through a medial endoscopic transnasal maxillectomy.



All patients who underwent transnasal endoscopic maxillectomy with ION transposition in our institute were retrospectively reviewed.



Two patients were identified who had been treated for sinonasal cancers using this approach. No major complications were observed. Transient loss of ION function was observed with complete recovery of skin sensory perception within 6 months of surgery. One patient referred to a mild permanent anesthesia of the upper incisors. No diplopia or enophthalmos were encountered in any of the patients.



The ION transposition is useful for selected cases of benign and malignant sinonasal tumors that do not infiltrate the ION itself but involve the surrounding portion of the maxillary sinus. Anatomic preservation of the ION seems to be beneficial to the postoperative quality of life of such patients.
Division of Maxillofacial Surgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
Giovanni
G
Salzano
Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.|Head and Neck Surgery and Forensic Dissection Research Center, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Mario
M
Turri-Zanoni
Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Apostolos
A
Karligkiotis
Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Jacopo
J
Zocchi
Division of Maxillofacial Surgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
Giovanni
G
Dell'Aversana Orabona
Division of Maxillofacial Surgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
Luigi
L
Califano
Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.|Head and Neck Surgery and Forensic Dissection Research Center, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Paolo
P
Battaglia
Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.|Head and Neck Surgery and Forensic Dissection Research Center, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Paolo
P
Castelnuovo
D000230:Adenocarcinoma / Q000601:surgery; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004724:Endoscopy; D006801:Humans; D008297:Male; D008442:Maxillary Nerve / Q000601:surgery*; D008443:Maxillary Sinus / Q000294:innervation / Q000601:surgery*; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects; D010255:Paranasal Sinus Neoplasms / Q000601:surgery
endoscopic endonasal approach; infraorbital nerve; maxillary sinus; maxillectomy; sinonasal cancer