A surgical approach as dysmasking in patients with malignant tumors of the paranasal sinuses and skull base

Abstract

A surgical approach as dysmasking implies a bitemporal skin incision followed by a single flap from upper facial soft tissues. The advantages of this technique may include a wide surgical approach to the structures of the anterior skull base, a possibility of intraoperative extension of the approach through parapalpebral and/or pre-auricular incisions, the lack of incisions in the central zone of the face, the preservation of the integrity of mimic muscles and the sensitivity of soft tissues in the central zone of the face. This paper gives experience in surgically treating 5 patients with malignant tumors of the paranasal sinuses and skull base. All the cases required a wide approach to the skull base and anterior facial skeleton. This was achieved by the use of the dysmasking approach, if need be, parapalpebral incisions or facial nerve resection followed by single-stage microsurgical neurorrhaphy were made. All operations were performed under endotracheal anesthesia. The wide surgical approach to the tumor, which permitted its removal in the maximum volume without skin incisions in the central zone of the face, as vitally indicated, could be achieved by dysmasking that yielded satisfactory postoperative cosmetic and functional results in all the cases.

Keywords

• dysmasking
• skull base tumors
• maxillary sinus tumor
• malignant paranasal sinus tumor
• parapalpebral incision
• surgical approach
• malignant skull base tumors
• bitemporal incision
• mucosal melanoma