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2014 ; 3
(ä): Doc06
Nephropedia Template TP
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English Wikipedia
Nasal meatus plasty: a contribution to plastic reconstruction of the nasal valve
during midfacial degloving
#MMPMID26504717
Lorenz KJ
; Maier H
; Wilde F
GMS Interdiscip Plast Reconstr Surg DGPW
2014[]; 3
(ä): Doc06
PMID26504717
show ga
Midfacial degloving is a proven method for easily accessing the midface, the
nasal pyramid, the maxillary and ethmoidal sinuses, the orbits, as well as the
anterior skull base. Indications for this method of access mainly include tumour
resections in the area of the midface, the septum, the maxillary sinus, the
paranasal to the sphenoidal sinus as well as the clivus. In addition, this method
of access allows for the exposure of the bony structures of the midface in the
event of extensive fractures. In general, this method of access combines an
incision in the oral vestibule and circular incisions in the nasal vestibule area
in order to release the nasal pyramid. After removing the facial wall of the
maxillary sinus, extensive exposure of the surgical site is possible. One
disadvantage of this method of access is the difficult reconstruction of the
nasal valve area, which often leads to cicatricial stenoses and difficulties with
breathing through the nose. Furthermore, wound healing problems and
osteoradionecrosis in the area of the lateral margin of the anterior nasal
aperture after replantation of the facial wall of the maxillary sinus have been
described, because in this area sufficient soft tissue coverage cannot be ensured
when a conventional technique is used. We describe a soft tissue flap pedicled in
the cranial and caudal directions in the nasal valve area which makes both the
reconstruction of the nasal vestibule and sufficient soft tissue coverage of the
anterior nasal aperture possible.