A craniofacial approach to advanced recurrent cancer of the central face

Recurrent penetrating midface cancer results from basal cell carcinoma, squamous cell carcinoma, adenocystic carcinoma, and chondrogenic and osteogenic sarcoma. In the past, surgical resection frequently resulted in meningitis. A combined neurosurgical and plastic surgical craniofacial approach has been used for total resection of these lesions. The floor of the anterior cranial fossa has been reconstructed with an extended glabellar flap incorporating a forehead Z-plasty. Over the past 2-and-a-half years, 10 patients have been operated on successfully. Five cases with a follow-up of over 2 years are presented.