A Case Series of Total Maxillectomy by Midface Degloving Approach

Background: The midface degloving approach allows for wide exposure of the maxilla and surrounding midfacial structures with intranasal and intraoral incisions, and is free of external facial incisions. It has been used in a variety of benign and sinonasal lesions but its use in total maxillectomy is relatively rare. This case series assessed the clinical usefulness and feasibility of midface degloving approach for total maxillectomy, and outlined the perioperative and postoperative outcomes. Material and Methods: This study is a retrospective case series, which was carried out in the Department of Otorhinolaryngology, Government General Hospital, Ananthapuramu, from October 2023 upto September 2025. Purposive sampling was used in which 8 patients who had total maxillectomy for various maxillary pathologies were included. All patients were clinically examined, a diagnostic nasal endoscopy was performed and a pre-operative computed tomography (CT) of the nose and paranasal sinuses was done. Operative parameters and postoperative complications, functional results, cosmetic results and follow-up findings were recorded. Descriptive statistics of IBM SPSS Statistics 29.0 were used for data analysis. Results: Among the eight patients, five (62.5%) were males and three (37.5%) were females, with ages ranging from 19 to 67 years. Osteomyelitis of maxilla was the most common in five (62.5%) patients followed by carcinoma of maxilla in two (25.0%) patients and fibrous dysplasia in one (12.5%) patient. Most of the patients were in the age group of 46-60 years (62.5%). The postoperative follow-up period varied between 8 and 23 months. Conclusion: The midface degloving approach allows for wide surgical access for a select patient undergoing total maxillectomy without external facial incisions and visible facial scars. It can be used in a wide variety of inflammatory, malignant and benign maxillary diseases, which shows its versatility. More extensive prospective comparative trials are needed to prove its efficacy and long-term results.

Keywords: Midface degloving, Total maxillectomy, Maxillary pathology, Sinonasal surgery, Facial aesthetics.