Two cases of parapharyngeal space tumor resected by a double split mandibular osteotomy technique. Issue 12 (26th December 2022)

• Record Type: Journal Article
• Authors: Kato, Shinichiro; Ijichi, Kei; Fukushima, Asako; Nakamura, Tomohisa; Takashima, Hiroyuki; Nabeta, Tsuyoshi; Miyamoto, Hironori; Ishibashi, Kenichiro; Tsuchiya, Shuhei; Hishida, Sumiyo; Shibuya, Yasuyuki
• Is Part Of: Clinical case reports. Volume 10:Issue 12(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-12-26
• Subjects: double split osteotomy -- mandibular osteotomy -- median lower lip incision -- parapharyngeal space tumor -- pleomorphic adenoma; Medicine -- Periodicals; 616.09
• DOI: 10.1002/ccr3.6786
• Languages: English
• ISSNs: 2050-0904

Abstract

Abstract: Parapharyngeal space tumors have poor subjective symptoms and often grow until diagnosed; therefore, mandibular transection may be needed to obtain a wider field of view during surgery. However, if a median lower lip incision is performed for the mandibular transection, esthetic problems occur after surgery. Here, we report two cases of parapharyngeal space tumors that were removed with a mandibular lateral segment‐osteotomy technique without median lower lip incision to avoid esthetic problems. Case 1 was a 49‐year‐old woman. She was aware of a right tonsillar swelling, and an imaging test revealed a tumor lesion 60 mm in size in the right parapharyngeal space. Case 2 was a 40‐year‐old woman with an abnormal position of the uvula, and an imaging test showed the left parapharyngeal space tumor lesion 45 mm in size. Both cases were diagnosed as a pleomorphic adenoma, and surgery under general anesthesia was performed jointly with otolaryngology and oral surgery. The incision was performed from the lower part of the right auricle to the anterior part of the submandibular area. After the tumor resection, the mandible was repositioned, fixed by plates, and the intermaxillary fixation was performed with a surgical stent. In both cases, slight paralysis of the mandibular branch of the facial nerve and the mental nerve was observed after the operation, but they were improved immediately. One year after the operation, the plates were removed. There have been no recurrences until now. Abstract : Surgical and postsurgical viewing of Case 1. (A) A double mandibular split osteotomy on the right side is performed completely. (B). After tumor resection. (C). A surgical stent is attached to confirm restoration of the occlusal position. (D). Postoperative face appearance without a cosmetic problem. M—mandible. Asterisk—medial pterygoid muscle. Arrows—split position.