Transmandibular approach to the malignant neoplasms of the mouth base, tongue root and oropharynx

Background and objectives : Controversy exists for the surgical approach of maxillary complex tumors extending deep into the oropharingeal cavity. Large resection margins are required, which in most cases cannot be achieved by conventional approaches. The objective of this study is to evaluate the transmandibular approach for removal of these neoplasms.

Materials and methods : We retrospectively review a series of 28 patients operated between 2006 and 2012, in whom a transmandibular approach was used for removal of tumors in the oropharyngeal cavity.

Results : By means of the transmandibular approach, 28 cases of malignant tumors in the oropharynx (33%), tongue (33%), retromolar trigone (27%) and soft palate (5.5%) have been operated. Negative surgical margins were achieved in 27 cases (96.4%). Primary reconstruction was carried out mostly with forearm fasciocutaneous flaps (53.57%) and anterolateral thigh flaps (17,8%). The most frequent complication found was surgical wound infection (17%), followed by ischemia of the flap (14%).

Conclusion : The transmandibular approach is a great ally for removal of tumors in the oropharyngeal cavity. It improves direct visualization and bleeding control, allowing tumor resection with negative margins and making primary reconstruction easier. The excellent cosmetic results, makes this technique of choice for the removal of these tumors.

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Jan 20, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Transmandibular approach to the malignant neoplasms of the mouth base, tongue root and oropharynx
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