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Vertical ramus osteotomy combined with a parasymphyseal mandibulotomy for improved access to the parapharyngeal space
Graham I Smith1, Peter A Brennan, Andrew A Webb
1Department of Maxillofacial Surgery/Head and Neck Surgery, Queen Alexandra Hospital, Portsmouth PO6 3LY, United Kingdom.
Background:
A number of procedures have been described that facilitate access to the parapharyngeal space. Their use may be limited because of restricted access or postoperative morbidity.
Methods:
We describe the use of two mandibular osteotomies to greatly enhance the exposure of the parapharyngeal space, with possible access up to the skull base.
Results:
We have performed this procedure in three cases with minimal postoperative morbidity and no neurologic deficit or occlusal disturbances.
Conclusions:
We have found that the osteotomies described provide far better exposure to this area than a single mandibular osteotomy alone. Furthermore, it avoids a facial scar.