Maxillary swing approach for removal of recurrent nasopharyngeal carcinoma

The maxillary swing approach is an elegant and versatile technique designed to facilitate access to the nasopharynx and middle cranial fossa skull base. The approach involves the disassembly of the bony connections between the maxilla and the adjacent facial skeleton, leaving the maxillary infrastructure pedicled on its anterolateral soft tissue attachments. Excellent oncologic and functional outcomes have been reported in selected patient cohorts with recurrent nasopharyngeal carcinoma. Success depends upon respecting rigid criteria for patient selection, having a comprehensive understanding of skull base anatomy, and adhering to meticulous surgical technique and oncologic principles.