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.