Jerry Castro1, Ilya Likhterov1, Saral Mehra2, Michael Bassiri-Tehrani1, Sophie Scherl1, Jason Clain1, Daniel Buchbinder3, Mark L Urken1. 1. Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A. 2. Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A. 3. Department of Oral, Maxillo-Facial Surgery and Otolaryngology, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: The aim of this study was to present our experience with management of malignant lesions arising within the masticator space, and to describe a technique of en bloc resection and reconstruction. STUDY DESIGN: Case series and case report. METHODS: Eight cases of masticator space malignancies treated surgically with en bloc resection and free flap reconstruction were retrospectively reviewed. RESULTS: Tumor extirpation was carried out through a parotidectomy approach with mobilization and protection of the facial nerve. Primary reconstruction was accomplished with vascularized bone containing free flaps, fibula (n = 4), scapula (n = 2), and scapula with latissimus dorsi muscle (n = 2). Mean follow-up was 62.5 months (range, 18-132 months). CONCLUSIONS: En bloc resection of masticator space malignancies can be consistently accomplished through an extended parotidectomy approach. The defect is best reconstructed with a vascularized bone and soft tissue free flap. Favorable functional and aesthetic outcomes can be successfully achieved using the techniques described in this series. LEVEL OF EVIDENCE: 4.
OBJECTIVES/HYPOTHESIS: The aim of this study was to present our experience with management of malignant lesions arising within the masticator space, and to describe a technique of en bloc resection and reconstruction. STUDY DESIGN: Case series and case report. METHODS: Eight cases of masticator space malignancies treated surgically with en bloc resection and free flap reconstruction were retrospectively reviewed. RESULTS: Tumor extirpation was carried out through a parotidectomy approach with mobilization and protection of the facial nerve. Primary reconstruction was accomplished with vascularized bone containing free flaps, fibula (n = 4), scapula (n = 2), and scapula with latissimus dorsi muscle (n = 2). Mean follow-up was 62.5 months (range, 18-132 months). CONCLUSIONS: En bloc resection of masticator space malignancies can be consistently accomplished through an extended parotidectomy approach. The defect is best reconstructed with a vascularized bone and soft tissue free flap. Favorable functional and aesthetic outcomes can be successfully achieved using the techniques described in this series. LEVEL OF EVIDENCE: 4.