Modifications of the mandibular swing for preservation of occlusion and function

The mandibular swing, or midline mandibular osteotomy with lateral mandibular displacement, provides excellent exposure equivalent to that obtained by composite resections of the mandible while minimizing cosmetic and functional disability and reducing the complexity of reconstruction. This procedure is most commonly described from an oncologic standpoint. Modifications of this procedure, performed on patients with adequate anterior mandibular height, provide access to lesions of the skull base, as well as benign lesions of the parapharyngeal space. Minor modifications of the midline mandibular osteotomy, as well as preservation of anterior mandibular dentition, provide these patients with immediate restitution of interocclusal anatomy and function.