Osteotomy in the vertical ramus outside the mandibular foramen for tumours in the parapharyngeal space

IntroductionAlthough several techniques have been described to access the parapharyngeal space, tumour surgery in this area remains a challenge. This study investigated a simple and safe technique to access parapharyngeal space tumours.Material and methodsEight primary parapharyngeal space tumours were treated with osteotomy of the vertical ramus outside the mandibular foramen. The primary tumours were pleomorphic adenoma, schwannoma, Warthin's tumour, lipoma, chordoma, and adenoid cystic carcinoma. Tumour size ranged from 4 × 4 cm to 6 × 7 cm. Patients with malignant tumours who underwent surgical resection also received adjuvant dose-fractionated stereotactic radiotherapy.ResultsAll tumours were removed completely without rupture. No patient exhibited any permanent postoperative complication, malocclusion, or other dental complications from this surgical approach. One patient had slight transient postoperative facial paresis, which resolved spontaneously within 4 weeks. The patients were followed for 7–26 months, during which no recurrence was encountered.ConclusionsOsteotomy of the vertical ramus outside the mandibular foramen achieved good exposure and satisfactory aesthetic and functional results. This simple and safe technique facilitates the removal of infratemporal fossa tumours while preserving the inferior alveolar nerve.