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.