New approach to the nasopharynx: the maxillary swing approach

A new approach to expose the nasopharynx and the paranasopharyngeal space is described. The maxilla, severed from its bony connections, is swung laterally to provide exposure of the nasopharynx. Tumors in the nasopharynx and the paranasopharyngeal space can be adequately resected and tubings for afterloading brachytherapy can be positioned accurately during surgery. The blood supply of the maxilla is from the attached cheek flap and masseter muscle. Three illustrative cases are presented. The wounds in all of them healed primarily with minimal morbidity. The only disadvantage is the development of mild trismus, which responded to conservative treatment.