SURGICAL TECHNIQUE Copyright © Celsius Publishing House J. Transl. Med. Res 2015;20(1):23-25 Journal of Translational Medicine and Research, 1 (20), 2014 23 The use of the reversed facial flap in midface reconstruction following advanced sinonasal malignancies Viorel Zainea 1,2 , Octavian Ceachir 2 , Irina Ioniţă 2 , Cătălina Pietroșanu 1,2 , Carmen Drăghici 1 , Cristina Zamfir 1 , Răzvan Hainăroșie 1,2 Corresponding author: Octavian Ceachir, MD 21 Mihail Cioranu Str., District 5, Bucharest, 050751 E-mail: octavianceachir@gmail.com ABSTRACT The objectives of the study: Advanced or recurrent sinonasal malignancies sometimes need, besides an ablative step, a reconstructive step. If this occurs, the reconstructive step may require advanced knowledge of reconstructive surgery because of the complex remnant defects after ablation. The methodology: The authors present a surgical reconstructive solution that can be used in cases of advanced sino nasal tumors which associate the destruction of the malar region. This requires a midfacial flap which will provide a solid support for the paramedial forehead flap. Conclusions: The use of the reversed midfacial flap is an original method that can provide a good mechanical support for any reconstructive flap in the midfacial region. Keyw ords: sino nasal malignancies, reconstruction, flap INTRODUCTION INTRODUCTION Advanced or recurrent sino nasal tumors require an ablative step followed preferably during the same surgical intervention by a reconstructive step [1]. Despite the advancement of the endoscopic surgical techniques, we believe that for advanced sino nasal malignancies the combined approach (endoscopic and external approach) is still the gold standard, considering that the main purpose is the complete removal of the tumor [2]. If that is not possible, it is preferable to remove the entire mass that can be resected, rather than perform a debulk- ing procedure[3]. In our experience we have encountered complex cases of sino nasal malignancies with extensive destruction at the level of the mid facial region. The challenge of the reconstructive step in the midfacial defect produced by advanced or recurrent sino nasal malignancies is the complex defects that involve the bone of the malar region and the dermal and subdermal structures. In order to achieve a good esthetic result after reconstruction a bony support is 1 Institiute of Phonoaudiology and Functional ENT Surgery “Prof Dr Dorin Hociota”, Bucharest, Romania 2 University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania