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National Journal of Maxillofacial Surgery
 
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CASE REPORT
Year : 2014  |  Volume : 5  |  Issue : 2  |  Page : 213-216

Double mandibular osteotomy with segmental mandibular swing approach to parapharyngeal space


Department of ENT and Head Neck Oncology, Chittaranjan National Cancer Institute, Kolkata, West Bengal, India

Correspondence Address:
Dr. Shouvanik Satpathy
Department of ENT and Head Neck Oncosurgery, Chittaranjan National Cancer Institute, 37 SP Mukherjee Road, Kolkata - 700 026, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-5950.154840

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Surgical removal of benign tumors of the Parapharyngeal space (PPS) is the treatment of choice. PPS tumors may remain undetected for long periods of time and large tumors in the PPS can extend into the Retropharyngeal Space or into the Infra-Temporal Fossa. Anatomically, the mandible represents a significant obstacle to successful PPS surgery. Except for very small tumors, it is difficult to remove larger tumors from this region without some form of mandibular retraction. The standard mandibular "swing" approach involves splitting of the lower lip and a single parasymphysis osteotomy for retraction of the mandible laterally to expose the PPS. However, the morbidity associated with midline lip split and anesthesia of the hemi-labial region caused by the severing of the mental nerve is an unwanted complication of this approach. In this article, we describe an easier double mandibular osteotomy (Segmental Mandibular Swing Approach) which avoids the morbidity associated with lip splitting or intra-oral mucosal incision but allows excellent exposure of the superior and lateral aspect of PPS for easier removal of large tumors in this region.


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