case_images: PMC11676026_01
case_images: (a) 3-D Reconstructed CT scan showing the destruction of part of the left maxilla, zygoma, infraorbital rim. (b) Axial CT scan showing loss of left maxilla, zygoma, nasal bones
case_images: JWACS-15-106-g001.jpg
case_images: PMC11676026_01_JWACS-15-106-g001.jpg
case_images: JWACS_182_23-f001
case_images: A computed tomography scan revealed left maxillary, palatal and orbital defect with hypertrophied left coronoid fused to the zygomatic complex [Figure 1].
case_images: (a) Nasopharynx direct visualisations while retrating the tongue forward with Macgills forceps (b) Transorbital intubation through the defect. (c) Intraoperative mouth opening of 5 cm achieved
case_images: JWACS-15-106-g002.jpg
case_images: PMC11676026_01_JWACS-15-106-g002.jpg
case_images: JWACS_182_23-f002
case_images: Anaesthesia for bilateral coronoidectomies, trismus release procedure, was achieved with blind transorbital since there was involvement of the left orbit, maxilla and palate that aided direct visualization of the nasopharynx [Figure 2].
case_images: Fistula closure Dingman retractor in place after nasal layer closure
case_images: JWACS-15-106-g003.jpg
case_images: PMC11676026_01_JWACS-15-106-g003.jpg
case_images: JWACS_182_23-f003
case_images: A buccal advancement flap was used to form the oral layer sutured to the palate and septal mucosa sutured to the outer split tissue close to the skin of the cheek achieving a complete fistula closure [Figure 3].
case_images: Patient at presentation and 3 weeks postoperatively showing good healing
case_images: JWACS-15-106-g004.jpg
case_images: PMC11676026_01_JWACS-15-106-g004.jpg
case_images: JWACS_182_23-f004
case_images: Patient was eager to go home and discharged after 3 weeks [Figure 4] and was lost to follow up.