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Recurrent Ameloblastoma of the Mandibular Ramus Resected Using a Modified High Perimandibular Approach: A Case

Atsushi Uesugi¹, Kumiko Kamada¹, Keiko Kudoh¹

¹Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan, tokushima-u.ac.jp.

Case Reports in Dentistry

|April 10, 2026

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Recurrent ameloblastoma of the mandibular ramus can be effectively treated using the extended high perimandibular approach. This surgical technique offers a wide operative field and satisfactory esthetic outcomes with no recurrence observed in a recent case.

Area of Science:

Oral and Maxillofacial Surgery
Surgical Oncology

Background:

Ameloblastoma, particularly the unicystic type, can recur after treatment due to its invasive nature.
Standard surgical approaches may not always provide adequate exposure for complete resection of recurrent mandibular ramus ameloblastoma.
The high perimandibular approach is a known technique for mandibular fractures, offering good exposure and nerve protection.

Purpose of the Study:

To describe the successful adaptation of the extended high perimandibular approach for resecting a recurrent ameloblastoma of the mandibular ramus.
To evaluate the efficacy, safety, and esthetic outcomes of this modified surgical technique.

Main Methods:

A case report of a 58-year-old male patient with recurrent ameloblastoma unicystic type on the mandibular ramus.

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Resection of the recurrent tumor using an extended high perimandibular approach with a 10 cm incision.

Postoperative follow-up for 3 years to monitor for recurrence and assess facial nerve function and esthetics.

Main Results:

Complete resection of the recurrent ameloblastoma was achieved using the extended high perimandibular approach.
No facial nerve paralysis occurred postoperatively.
No recurrence was observed during the 3-year follow-up period, with satisfactory esthetic results.

Conclusions:

The extended high perimandibular approach is a viable and effective surgical option for managing recurrent ameloblastoma on the lateral surface of the mandibular ramus.
This technique provides adequate surgical exposure for complete tumor removal while preserving facial nerve function and achieving good esthetic outcomes.