Maxillary swing approach - Sri Lankan experience

Introduction: The maxillary swing approach is one of the trans maxillary surgical approach techniques used in otorhinolaryngology. It gives wide exposure to the nasopharynx, orbital apex, sphenoid sinus pterygopalatine fossa, infra temporal fossa and middle cranial base. This enables en bloc resections of tumour and proper visualization.   Objectives: To study patients who underwent this procedure during the last five years with regard to indication, technique, and complications. To compare our patient outcomes with the published literature. To identify the factors leading to complications with recommendations to reduce them in the future. Methods: Retrospective analytical study was done on patients operated from 2015 to 2020 at the ENT Unit C of the National Hospital of Sri Lanka (NHSL). Results: A total of 14 patients underwent maxillary swing approach during the study period. The most common indication was angiofibroma. About 28% had an unacceptable scar following the surgery, which was the most occurring complication while 2 patients had recurrences during this period. Conclusion: Maxillary swing is a useful surgical approach with no major complications in our series. Commonest complication was an unacceptable scar (28%).  Other complications were palatal fistula and nasal speech. It is postulated that further refinement of the technique will reduce these complications.