Analysis of the surgical treatment of the tumors in infratemporal fossa by mandibular swing approach / 实用口腔医学杂志

Objective:To analyse the effects of mandibular swing approach in the treatment of the tumors in infratemporal fossa. Methods:11 patients with tumors in infratemporal fossa treated by the surgical operation with mandibular swing approach. The mandi-ble cut was at the front of foramina mentale in 5 cases, at the front of mandible angle in 4 cases and at the middle of chin in 2 cases re-spectively. Results:According to the nature, location, size and the relationship of the tumors with peripheral nerve and blood vessels, flexible selection of the position of mandibular cut could fully expose and completely remove the infratemporal fossa tumor. Conclusion:Surgical treatment of the tumors in infratemporal fossa by mandibular swing approach is safe and effective.

Surgery for the Base of the Tongue Cancer in Conjunction with Supraglottic Partial Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cancer arising in the base of the tongue with extension to the supraglottic larynx or cancer of the epiglottis with extension to the base of the tongue require wider surgical approach than conventional supraglottic partial laryngectomy. This paper is to review techniques and postoperative results of mandibular swing approach for resection of the base of the tongue with supraglottic larynx. MATERIALS AND METHODS: We applied mandibular swing approach for three cases of the base of tongue cancer with significant extension to supraglottis. Two patients were stage T3 and the other was T4. RESULTS: In two patients, oral feeding without aspiration was possible with 5X6, 4X5 cm sized base of the tongue resection. Reconstruction was performed using primary repair between resected margin of the tongue and thyroid cartilage. In one case, an unexpected wide submucosal tumor extension to the hypopharynx was found, so a total glossolaryngectomy had to be performed. CONCLUSION: Resection of the base of the tongue beyond foramen cecum and primary repair may be possible without jeopardizing postoperative deglutition. Mandibular swing approach in conjunction with supraglottic partial laryngectomy was useful for the base of tongue cancer with supraglottic extension.

Mandibulotomy for The Approach to The Oral Cavity, Oropharynx and Skull Base / 대한이비인후과학회지

BACKGROUND: Adequate exposure of skull base lesion and intraoral lesion occupying the posterior oral cavity, base of tongue, tonsil, superior hypopharynx, anterior skull base, and infratemporal space for wide-field primary surgical resection is critical to tumor ablation. The division of mandible for resection of tumor was first undertaken by Roux in 1836, and many studies renewed the interest of mandible sparing procedure for surgical treatment of oropharyngeal carcinoma. OBJECTIVES: Mandibular swing approach for gaining access to oral cavity, oropharynx, and skull base for excision of tumor, provides excellent exposure with low complication rate when there is intervening grossly normal tissue between the tumor and bone. We studied mandibular swing approach with our surgical experience, with special emphasis on its subtypes related to osteotomy sites and forms. MATERIALS AND METHOD: The records of 20 patients underwent mandibular swing approach at Hanyang University Hospital, were studied by chart review. The patients were retrospectively reviewed to assess age, sex, tumor site origin, stage of disease, types of neck dissection and methods of the reconstruction, types of the mandibular osteotomies, and difference of complication rates between symphyseal and parasymphyseal osteotomy. RESULTS: Post-operative complications occured in 6 patients(30%). But osteotomy related complication rate was 15%. Complications of osteotomy site occurred at a rate of 20% in the symphyseal osteotomy group, but no complications arose in parasymphyseal osteotomy group. CONCLUSIONS: We believe that, if the mandible is clinically and radiologically clear of malignant involvement, midline mandibulotomy is more feasible surgical approach method for treatment of oral cavity, oropharyngeal, skull base lesion.