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Lateral Transmandibular Approach to the Skull Base in Children: Three Case Reports
Christian Kuettner1, M Samii2, J E Hausamen1
1Department of Oral and Maxillofacial Surgery, Hannover University Hospital, Hannover, Germany.
Summary
This study presents a modified lateral transmandibular approach for pediatric cranial base tumors, achieving good surgical results with minimal impact on facial growth. Mandibular growth impairment was successfully addressed using distraction osteogenesis.
Area of Science:
- Pediatric Neurosurgery
- Cranial Base Surgery
- Surgical Oncology
Background:
- Cranial base tumors in children require surgical approaches balancing tumor resection with facial growth preservation.
- Key criteria include optimal surgical visibility, minimal facial skull growth impairment, and nerve integrity.
Observation:
- A modified lateral transmandibular approach was utilized in three pediatric patients (ages 6 months to 6 years) between 1993 and 1996.
- The technique involved a preauricular incision with temporal/submandibular extensions, mandibular osteotomy, and temporary capitulum disarticulation for wide cranial base access.
Findings:
- Successful resection of cranial base tumors was achieved in all three pediatric patients.
- Post-operative follow-up in two patients indicated good treatment outcomes.
- Mandibular growth impairment, a potential complication, was effectively corrected using distraction osteogenesis.
Implications:
- The modified lateral transmandibular approach offers a viable surgical option for pediatric cranial base tumors.
- This technique demonstrates the potential to achieve oncological goals while mitigating long-term functional and aesthetic deficits.
- Distraction osteogenesis serves as an effective method for correcting post-surgical mandibular deformities in pediatric patients.