Access to the Skull Base - Maxillary Swing Procedure - Long Term Analysis

Overview

Journal Ann Maxillofac Surg

Date 2018 Jul 3

PMID 29963431

Citations 5

Authors

Gurudayal Singh Kalra

Manojit Midya

Mitesh Bedi

Affiliations

Soon will be listed here.

Abstract

Background: Skull base is difficult to approach surgically due to its complex anatomy. A number of procedures that is endoscopic, microscopic, and open approaches have been used. The maxillary swing approach provides a wide exposure to the surgeon for better oncological clearance.

Patients And Methods: A total of 62 patients with varied etiologies involving the skull base region were operated with maxillary swing procedure over a period of 15 years from 2001 to 2016 in plastic surgery department at a single institution.

Results: There was no recurrence in the follow-up period. One patient had palatal fistula and one patient had mild nasal mucosal atrophy. None of the patients had malocclusion in the postoperative period. The minimum follow-up period was 24 months.

Conclusion: Maxillary swing procedure provides excellent exposure to skull base, and most of the tumors involving this region can be effectively excised with minimal morbidity to the patient.

Citing Articles

Surgical Management of Complex Skull Base Tumor Using Preoperative Multimodal Image Fusion Technology.

Jian Z, Chen P, Li Y, Liao C, Yi X, Zhan R J Craniofac Surg. 2024; .

PMID: 38534161 PMC: 11045550. DOI: 10.1097/SCS.0000000000010073.

Novel Modifications to Total Maxillary Swing Approach in Extensive Nasopharyngeal Angiofibroma to Minimize Complications.

Bhardwaj A, Priya M, Malhotra M, Varshney S, Tyagi A, Singh A Indian J Otolaryngol Head Neck Surg. 2022; 74(Suppl 2):1120-1127.

PMID: 36452589 PMC: 9702321. DOI: 10.1007/s12070-020-02181-5.

Aggressive Treatment Including Endonasal Surgical Sequestrectomy with Vascularized Nasoseptal Flap Can Improve Outcomes of Skull Base Osteoradionecrosis.

Cho S, Han S, Song Y, Kim J, Kim H, Kim D J Neurol Surg B Skull Base. 2022; 83(Suppl 2):e15-e23.

PMID: 35832995 PMC: 9272258. DOI: 10.1055/s-0040-1722669.

Modified Maxillary-Swing Approach for Resection of Primary Malignancies in the Pterygopalatine Fossa.

Xie L, Huang W, Wang J, Zhou Y, Chen J, Chen X Front Oncol. 2020; 10:530381.

PMID: 33240804 PMC: 7682189. DOI: 10.3389/fonc.2020.530381.

Transpalatal Approaches to the Skull Base and Reconstruction: Indications, Technique, and Associated Morbidity.

London Jr N, Chan J, Carrau R Semin Plast Surg. 2020; 34(2):99-105.

PMID: 32390777 PMC: 7202914. DOI: 10.1055/s-0040-1709432.

References

Jackson I, Hide T . A systematic approach to tumours of the base of the skull. J Maxillofac Surg. 1982; 10(2):92-8. DOI: 10.1016/s0301-0503(82)80019-2. View

Ng R, Wei W . Elimination of palatal fistula after the maxillary swing procedure. Head Neck. 2005; 27(7):608-12. DOI: 10.1002/hed.20220. View

Ammirati M, Ma J, Cheatham M, Mei Z, Bloch J, Becker D . The mandibular swing-transcervical approach to the skull base: anatomical study. Technical note. J Neurosurg. 1993; 78(4):673-81. DOI: 10.3171/jns.1993.78.4.0673. View

Scholz M, Parvin R, Thissen J, Lohnert C, Harders A, Blaeser K . Skull base approaches in neurosurgery. Head Neck Oncol. 2010; 2:16. PMC: 2913918. DOI: 10.1186/1758-3284-2-16. View

Ammirati M, Bernardo A . Analytical evaluation of complex anterior approaches to the cranial base: an anatomic study. Neurosurgery. 1998; 43(6):1398-407; discussion 1407-8. DOI: 10.1097/00006123-199812000-00081. View

Donald P . History of skull base surgery. Skull Base Surg. 1991; 1(1):1-3. PMC: 1656314. DOI: 10.1055/s-2008-1056983. View

Suarez C, Llorente J, Munoz C, Garcia L, Rodrigo J . Facial translocation approach in the management of central skull base and infratemporal tumors. Laryngoscope. 2004; 114(6):1047-51. DOI: 10.1097/00005537-200406000-00017. View

Krischek B, Carvalho F, Loyola Godoy B, Kiehl R, Zadeh G, Gentili F . From craniofacial resection to endonasal endoscopic removal of malignant tumors of the anterior skull base. World Neurosurg. 2014; 82(6 Suppl):S59-65. DOI: 10.1016/j.wneu.2014.07.026. View

Moreira-Gonzalez A, Pieper D, Cambra J, Simman R, Jackson I . Skull base tumors: a comprehensive review of transfacial swing osteotomy approaches. Plast Reconstr Surg. 2005; 115(3):711-20. DOI: 10.1097/01.prs.0000152437.71574.4f. View

10.

King W, Ku P, Mok C, Teo P . Nasopharyngectomy in the treatment of recurrent nasopharyngeal carcinoma: a twelve-year experience. Head Neck. 2000; 22(3):215-22. DOI: 10.1002/(sici)1097-0347(200005)22:3<215::aid-hed2>3.0.co;2-b. View

11.

Chan J, Tsang R, Wei W . Morbidities after maxillary swing nasopharyngectomy for recurrent nasopharyngeal carcinoma. Head Neck. 2014; 37(4):487-92. DOI: 10.1002/hed.23633. View

12.

Wei W, Ho C, Yuen P, Fung C, Sham J, Lam K . Maxillary swing approach for resection of tumors in and around the nasopharynx. Arch Otolaryngol Head Neck Surg. 1995; 121(6):638-42. DOI: 10.1001/archotol.1995.01890060036007. View

13.

Richardson M . Pathology of skull base tumors. Otolaryngol Clin North Am. 2001; 34(6):1025-42, vii. DOI: 10.1016/s0030-6665(05)70363-7. View

14.

Pendleton C, Adams H, Salvatori R, Wand G, Quinones-Hinojosa A . On the shoulders of giants: Harvey Cushing's experience with acromegaly and gigantism at the Johns Hopkins Hospital, 1896-1912. Pituitary. 2010; 14(1):53-60. DOI: 10.1007/s11102-010-0258-z. View

15.

Khanna J, Natrajan S, Galinde J . Skull base tumors: a kaleidoscope of challenge. J Neurol Surg Rep. 2014; 75(1):e11-21. PMC: 4110132. DOI: 10.1055/s-0033-1358381. View

16.

Hao S, Tsang N, Chang C . Salvage surgery for recurrent nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2002; 128(1):63-7. DOI: 10.1001/archotol.128.1.63. View

17.

Wei W, Lam K, Sham J . New approach to the nasopharynx: the maxillary swing approach. Head Neck. 1991; 13(3):200-7. DOI: 10.1002/hed.2880130306. View

18.

Pieper D, LaRouere M, Jackson I . Operative management of skull base malignancies: choosing the appropriate approach. Neurosurg Focus. 2005; 12(5):e6. DOI: 10.3171/foc.2002.12.5.7. View

19.

KETCHAM A, Wilkins R, VANBUREN J, Smith R . A COMBINED INTRACRANIAL FACIAL APPROACH TO THE PARANASAL SINUSES. Am J Surg. 1963; 106:698-703. DOI: 10.1016/0002-9610(63)90387-8. View

20.

Roy Chowdhury S, Rajkumar K, Deshmukh T . Complications of Midface Swing for Management of Juvenile Nasopharyngeal Angiofibroma. J Maxillofac Oral Surg. 2017; 16(1):96-100. PMC: 5328877. DOI: 10.1007/s12663-016-0947-x. View