BACKGROUND: Tumors involving the parapharyngeal space present a challenge of surgical access. METHODS: We reviewed all parapharyngeal space tumors resected at the University of California, San Francisco, between 2003 and 2006 and identified 14 patients who had a mandibular osteotomy to enhance surgical access to the parapharyngeal space. RESULTS: The surgical approach for the 14 patients who had a mandibulotomy was accomplished via either 1 or 2 mandibular osteotomies. A single paramedian osteotomy between the canine and the first premolar was used in 4 cases, whereas a combination of a horizontal osteotomy above the lingula and a paramedian osteotomy between the canine and first premolar was employed in 8 cases. A lingual dental splint and rigid fixation were used to achieve mandibular stabilization and fixation. CONCLUSION: We found that the single and double mandibular osteotomies provided excellent surgical access allowing for total tumor removal with few sequelae. (c) 2008 Wiley Periodicals, Inc. Head Neck, 2009.
BACKGROUND:Tumors involving the parapharyngeal space present a challenge of surgical access. METHODS: We reviewed all parapharyngeal space tumors resected at the University of California, San Francisco, between 2003 and 2006 and identified 14 patients who had a mandibular osteotomy to enhance surgical access to the parapharyngeal space. RESULTS: The surgical approach for the 14 patients who had a mandibulotomy was accomplished via either 1 or 2 mandibular osteotomies. A single paramedian osteotomy between the canine and the first premolar was used in 4 cases, whereas a combination of a horizontal osteotomy above the lingula and a paramedian osteotomy between the canine and first premolar was employed in 8 cases. A lingual dental splint and rigid fixation were used to achieve mandibular stabilization and fixation. CONCLUSION: We found that the single and double mandibular osteotomies provided excellent surgical access allowing for total tumor removal with few sequelae. (c) 2008 Wiley Periodicals, Inc. Head Neck, 2009.