TRANSMANDIBULAR TRANSPTERYGOID APPROACH TO THE PARAPHARYNGEAL SPACE AND SKULL BASE

DOI 6 References Open Access
  • HYODO Masamitsu
    Department of Otolaryngology, School of Medicine, Ehime University
  • YUMOTO Eiji
    Department of Otolaryngology, School of Medicine, Kumamoto University
  • KAWAKITA Seiji
    Department of Otolaryngology, School of Medicine, Ehime University

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Other Title
  • 副咽頭腔から外頭蓋底へのアプローチ―経翼突法の経験―
  • 経翼突法の経験

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Description

The upper part of the parapharyngeal space, including nasopharynx and skull base, is relatively difficult to access without serious postoperative morbidity. A transmandibular transpterygoid approach for lesions in this region has been used in 20 patients. The lesions consisted of mesopharyngeal carcinoma with an invasion to the parapharyngeal space in 9, residual nasopharyngeal carcinoma after full doses of radiotherapy in 5, large neurinoma extending into the jugular foramen in 2, and others in 4. Of 20 patients that underwent this procedure, local recurrence occurred only in 3 patients with mesopharyngeal carcinoma or chordoma. Blood loss during surgery was insignificant, and postoperative nerve deficits were minimal. In conclusion, the transmandibular transpterygoid approach can provide surgeons a wide and close surgical field necessary for safe and radical removal of parapharyngeal lesion, particularly of malignant tumor.

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