[Application of maxillary swing approach in operation of para-pharynx and cranial base]

The efficacy of the maxillary swing approach to the nasopharynx and its vicinity was evaluated.

Using maxillary swing approach, the tumors in the nasopharyngeal region and infratemporal fossa in 60 patients were removed at the Department of Head and Neck Surgery, Cancer hospital, Chinese Academy of Medical Sciences during the period 1995 to 2005. Among them, 51 suffered from primary nasopharyngeal and cranial base tumor, and 9 had tumor of primary infratemporal fossa. Thirteen patients had benign and 47 patients had malignant tumor. Twenty eight cases were received preoperative radiotherapy.

The facial wounds in all 60 patients healed primarily with no evidence of necrosis of the maxilla Twelve patients developed palatal fistula, six of them subsequently healed, two patients did not request surgical closure, whereas two patients required to wear a dental plate. Patients were followed up from 5 to 85 months (median interval, 38 months). Fourteen patients had local recurrence after treatment and five of them died. Three patients developed pulmonary metastasis. Five year survival and free tumor survival of malignant tumor were 76.4% and 36.3%, respectively.

The maxillary swing approach is a proven method for access to the nasopharynx, middle cranial base and infratemporal fossa. The tumors in these regions can be adequately exposure and safely resected. The associated morbidity is low and there is no postoperative disturbance of cosmetic appearance using this approach.