Aggressive maxillofacial disassembly in skull base surgery

OBJECTIVE: To review our favorable experience with maxillofacial disassembly for exposure and resection of tumors of the skull base. PATIENTS AND METHODS: This is a retrospective review of 31 patients from 1997 to 2005 treated by maxillofacial disassembly and includes 22 patients with midface disassembly and 9 patients with mandible with or without midface disassembly. RESULTS: Follow-up ranges from 2 weeks to 7 years: 23 (74.2%) of 31 patients are alive and disease free; 3 patients are alive with disease; 3 patients have died of distant metastasis. There were 14 complications in 12 (38.7%) patients; 13 of 14 complications were minor. One major complication (cardiovascular accident) resulted in the single postoperative mortality in this series. CONCLUSION: Our technique of maxillofacial disassembly allows for tailored exposure of all regions of the anterolateral skull base with acceptable perioperative morbidity in appropriately selected patients. EBM RATING: C-4.