Lefort I Osteotomy for Angiofibroma Tumor with Wide Extension in Skull Base: A Report of 8 cases

Lefort I osteotomy is widely used in orthognatic orthodontic surgical operation which fascilitates the easy access to skull base, clavius and first cervical vertebra. Angiofibroma is a highly vascular tumour which, at stage III, can invade skull base or extends into the cranium or the diverticula through natural skull foraminae. In this retrospective study we report 8 cases who were operated upon by Lefort I osteotomy method and the outcome of which was compared with the results from other methods in regards to disease control and prevention of recurrence. Furthermore, because of the instability nature of tumour, particularly after the surgical intervention and manipulation, there is as yet commonly accepted surgical method that can identify and remove the tumour residues at the depth of operation site. So far 65 different methods have been studied for the control of such tumours. At present eight surgical operation approaches have been favoured and regarded by reputed specialists to be the most common and rational ones, namely: trans- nasal, palatal, hyoid, antrum, maxillary, zygoma, craniufronta and lateral rhinotomy. In this paper, we report 8 cases of angiofibroma with wide extention to the skull base. All patients were operated by Lefort I osteotomy with or without endoscopy and monitoring. Seven cases were controlled with no recurrence. This was compared favourably to 33.3% success rate in 15 cases who were operated by other methods in 1375- 80 in Amiralam Hospital and by the conventional surgical approach which had 50% success rate as reported by chandlers in staging III.