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We thank Janecka for his commentary. Although our incisions are similar to those used in the facial translocation, they are standard incisions previously described by Weber-Fergusson. The basis of the osteoplastic maxillotomy is the pedicled osteoplastic unit, comprised of vascularized bone, muscle, skin, and mucosa, whose design can be tailored to the desired skull-base exposure. The concept of a large osteoplastic unit that can be mobilized to access the cranial base and corresponding intracranial anatomy had not been previously described.
The osteoplastic maxillotomy is a modification of other techniques such as the facial translocation that were previously described. It is our opinion that no single transfacial approach previously described provides the necessary versatility, durability, and wide exposure for modern cranial base surgery.