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Skull base surgery. 1993 April; 3(2): 60–68.
PMCID: PMC1656424

Access to the Central Skull Base Via a Modified Le Fort I Maxillotomy

The Palatal Hinge Flap


We describe a modification of the standard Le Fort I maxillotomy in favor of a unilateral palatal hinge flap. Used in combination with a partial medical maxillectomy, submucous resection of the nasal septum, and contralateral inferior turbinectomy, this approach provides direct access to the entire nasal cavity, ipsilateral maxillary antrum, pterygopalatine fossa, nasopharynx, clivus, and first two cervical vertebrae. Use of the palatal hinge serves both to maintain palatal vascularity and eliminates the need for intermaxillary fixation. Facial incisions are avoided through a midfacial degloving approach. A variety of other surgical techniques used to access the central skull base are critically reviewed and compared with this new technique.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
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