The double mandibular osteotomy for vascular and tumor surgery of the parapharyngeal space

Publication date: Available online 15 November 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Thomas Schlieve, Eric R. Carlson, Michael Freeman, Ryan Buckley, Josh Arnold
PurposeThe purpose of this study is to describe our experience utilizing a double mandibular osteotomy for access to the parapharyngeal space in vascular and tumor surgery and to report on the outcomes and complications of this procedure.Patients and MethodsThe authors designed and implemented a case series to review the medical records of all patients treated with a double mandibular osteotomy for parapharyngeal space access from 1994 to 2016. Patient demographics, indication for the procedure, outcomes, and complications were recorded.ResultsA total of 17 patients underwent a double mandibular osteotomy procedure for access to the parapharyngeal space during the study period. There were 7 males (47%) and 10 females (53%) comprising the cohort. The average age was 57 years (range 29-75 years). Follow up ranged from 6-98 months (mean 40 months) and seven (41%) of patients were tobacco users at the time of surgery. The most common indication was high internal carotid artery stenosis (n =6) followed by carotid body paraganglioma (n = 3). Average blood loss was 186 mL and there were no deaths during the study period. Eight post-operative complications were noted in seven patients (41%). No procedures were aborted or compromised due to inadequate parapharyngeal space access. All patients realized clinical and radiographic signs of healing of their osteotomy sites.ConclusionThe double mandibular osteotomy provides adequate access to the parapharyngeal space for effective tumor removal and high carotid surgical intervention with acceptable patient morbidity and complications.



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