THE EVALUATION OF THE LE FORT I OSTEOTOMY APPROACH

Material-Method: Between 1990 and 2003, 15 cases that had undergone skull base and paranasal sinus tumors resection via the Le Fort I osteotomy approach were analyzed retrospectively. Tumor type, location, and size; intraoperative and postoperative complications; and residual tumor and/or tumor recurrence were reviewed for surgical approach.

Results: The age of the cases were 6-43 years (mean: 16.2 years), and the cases were 14 male,1 female. The Le Fort I osteotomy approach was used in 11 angiofibroma, 1 sfenoid sinus ca, 1 sfenoid sinus mucosel, 1 sfenoid sinus fibrous dysplasia and 1 maxiller fibrous dysplasia. Angiofibroma constituted 3 in stage II, 4 in stage III, 4 in stage IV, and the cases of the stage IV were treated with Le Fort I osteotomy I+ preauricular infratemporal approaches. One patient had residual tumor, and one patient developed tumor recurrence. Postoperative complications attributable to the approach were loss of tooth in one patient and epiphora in one patient.

Conclusion: Le Fort I osteotomy approach is a cosmetic technique which provide excellent surgical exposure and may be safely used in pediatric cases for the removal of extensive central skull base and paranasal sinuses tumors. This approach should be first considered for the treatment of these tumors in the cases. Keywords : LeFort I osteotomy, skull base tumors, angiofibroma