Midfacial degloving approach for repair of naso-orbital-ethmoid and midfacial fractures.

OBJECTIVE: To demonstrate that the midfacial degloving (MFD) approach can provide the proper exposure to successfully reduce naso-orbital-ethmoid (NOE) and midfacial fractures while eliminating the need for external skin incisions.

DESIGN: A retrospective review of patients with NOE and concomitant midfacial fractures that were repaired via the MFD approach for exposure.

SETTING: Tertiary care academic medical center.

METHODS: The MFD approach was used to access NOE and concomitant midfacial fractures for repair in 9 patients with facial trauma. Physical examination and imaging studies were used for preoperative evaluation. Functional and cosmetic results were assessed during follow-up with serial physical examinations and postreduction films.

RESULTS: No significant technical problems were encountered in the treatment of NOE and concomitant fractures, which included 5 Le Fort I, 1 Le Fort II, 1 Le Fort III, 6 orbital rim (1 superior, 4 inferior, and 1 lateral), and 4 zygomatic complex fractures. Physical examination and imaging studies showed adequate reduction in all patients, and all patients were satisfied with their short- and long-term functional and cosmetic results.

CONCLUSION: The MFD approach can provide the necessary exposure to properly reduce NOE and midfacial fractures without the need for external skin incisions.