Mandibular access osteotomy: Gate way to parapharyngeal space – A case report
| Autor: | Surej kumar l k, Jacob Mm, Dilna S |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Orthodontics
Mandibular access osteotomy business.industry medicine.medical_treatment Radiography Mandible Cosmesis Osteotomy stomatognathic diseases 03 medical and health sciences Skull 0302 clinical medicine medicine.anatomical_structure stomatognathic system Tongue 030220 oncology & carcinogenesis Case report Para pharyngeal space tumors medicine Parapharyngeal space Hypoglossal nerve tumor Facial skeleton 030211 gastroenterology & hepatology Surgery business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2021.105683 |
| Popis: | Highlights • Parapharyngeal space is an anatomically complex and difficult to access terrain for surgical interventions. • Tumours originating from or extending into the parapharyngeal space are rare and literatures are suggestive of the occurrence of only 0.5% among all head and neck tumours. • The aims of choosing the right approach should be complete removal of lesion, maintenance of occlusion and good temporomandibular function and preservation of inferior alveolar nerve. • Performing the osteotomy anterior to mental foramen preserves the inferior alveolar nerve and the osteotomy between the teeth avoids the need of tooth removal. • Out of the numerous techniques mandibular swing approach is a good option for skull base tumors because of the ease of technique even in inexperienced hands. Introduction Para pharyngeal tumors often pose a challenge to surgeons for surgical interventions. Maxillofacial access osteotomies offer excellent visualization and permit unhindered surgical manipulation. Access osteotomy allows the surgeon an adequate access of the surgical field to resect the tumor completely and to preserve vital structures. Though numerous techniques exist, selection of the proper technique is the key factor in reestablishing the function and cosmesis. This article describes our experience with mandibular swing approach that has facilitated complete removal of a parapharyngeal space tumor. Case presentation 35years old female complained of deviation of tongue to one side and swallowing difficulty. Clinical and radiographic examinations were suggestive of a skull base lesion involving the hypoglossal nerve. After evaluation the tumor was excised through a mandibulotomy approach. Post operatively the patient was relieved completely of the symptoms and without any postoperative sequalae. Clinical discussion Accessibility is the main concern while dealing with skull base lesions. But the success of surgery lies on the selection of right approach. Paramedian mandibular swing approach has its own advantages over various other facial osteotomies. The swinging of the mandible gives advantage of accessing neck and skull base together, which is not possible with other facial osteotomies. Conclusion Management of skull base tumors involve a multidisciplinary approach. Choosing the right approach is often a major dilemma. Access osteotomies of facial skeleton is a hatchway to the skull base lesions. Of which mandibular swing approach is a good option for skull base tumors because of the ease of surgical technique even in inexperienced hands. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|