LeFort I osteotomy approach to the anterior skull base

Anterior skull base neoplasms require a multispecialty approach for adequate resection and reconstruction. Otolaryngologists are often consulted to help provide access to middle cranial fossa tumors or treat anterior cranial base pathology that arises from the nasal cavity or paranasal sinuses. The...

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Published inOperative techniques in otolaryngology--head and neck surgery Vol. 21; no. 1; pp. 22 - 25
Main Authors Sirjani, Davud, MD, Futran, Neal, MD, DMD
Format Journal Article
LanguageEnglish
Published Elsevier Inc 01.03.2010
Subjects
Downfracture
Fixation
LeFort
Neoplasm
Osteotomy
Otolaryngology
Surgery
Neoplasm
Fixation
LeFort
Osteotomy
Downfracture
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Summary:Anterior skull base neoplasms require a multispecialty approach for adequate resection and reconstruction. Otolaryngologists are often consulted to help provide access to middle cranial fossa tumors or treat anterior cranial base pathology that arises from the nasal cavity or paranasal sinuses. The LeFort I osteotomy with downfracture of the maxilla is one of many well-described osteoplastic anterior transfacial approaches to access these areas of the skull base. The approach greatly improves visualization of not only the central skull base, but also the infratemporal fossa when the posterior wall of the antrum and the pterygoid plates are removed. We will review proper patient selection, the anatomy, and surgical exposure with modifications of the LeFort I osteotomy, operative procedure, and complications. This approach should be included in the skull base surgeon's repertoire as an intermediate alternative to limited access transnasal, transantral, and endoscopic approaches and wide exposure face-splitting procedures.
ISSN:1043-1810
1557-9395
DOI:10.1016/j.otot.2009.06.007