A new approach for the large parapharyngeal tumor; A sliding door approach

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Treating a parapharyngeal tumor is still a challenge for Otolaryngologists, as the anatomical condition of parapharyngeal space prevents a surgeon to access this space easily.For a large parapharyngeal tumor, the mandibular swing approach is the method of choice because of wide surgical field and low morbidity. But this approach demands midf acial skin incision including lip splitting giving a grave cosmetic effect. Our new mandibular osteotomy consisits of the lower condylar osteotomy and temporary posterior marginal resection of the ramus. That proedure enable the mandible to be retracted anteriorly like a sliding door that assure wide operative field from the skull base to the bottom of the parapharyngeal space. We had an excellent surgical result in a 39-year-old man with a large (9x8x6 cm) parapharyngeal basal cell adenoma. We think this method is one of the ideal approach to the large and/or malignant parapharyngeal tumor without a obvious facial scar.
特定非営利活動法人日本頭頸部外科学会の論文