Scarless total maxillectomy: midfacial degloving with extended transconjunctival retrocaruncular approach

Large benign and malignant tumours of the maxillary sinus may require a total maxillectomy as part of their treatment.1 Traditionally access has been by the Weber-Fergusson incision, or one of its modifications. This gives excellent exposure, particularly if the resection needs to extend above the orbital floor, but can be associated with extensive complications that include ectropion, shortening of the lip, breakdown of the wound, and facial scars. The midfacial degloving approach avoids these visible scars, but usually does not provide sufficient access to resect as far as the lamina papyracea and ethmoids.

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