Mandibular “swing” approach for oral and oropharyngeal tumors

Spiro, Ronald H.; Gerold, Frank P.; Strong, Elliót W.

doi:10.1002/hed.2890030505

Cited by 142 publications

(70 citation statements)

References 2 publications

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“…In addition, these studies founded the concept that high-risk-factor disease, such as positive margins, necessitates higher radiotherapy doses [7]. These principles of elective and comprehensive neck irradiation were investigated as an alternative treatment strategy [8] to standard aggressive and often functionally debilitating open surgical procedures [9,10].…”

Section: Historical Management Of Resectable Oropharyngeal Carcinomamentioning

confidence: 99%

Transoral robotic surgery and a paradigm shift in the management of oropharyngeal squamous cell carcinoma

2010

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Efforts to improve upon oncologic results for resectable oropharyngeal carcinoma over the past 40 years have yielded many treatment options. However, the two fundamental approaches, surgical and nonsurgical, have not been compared in a randomized trial. Both approaches can be effective and both can cause treatment-related swallowing complications. Early experience combining technological advancements with conformal radiotherapy and transoral robotic surgery suggests that the risk of swallowing complications may be reduced and that treatment outcomes may be improved through pathologic stratification and risk-adapted adjuvant therapy. This may also be a valid strategy upon which treatment de-intensification may be studied for human-papillomavirus-associated oropharyngeal carcinoma due to its favorable prognosis.

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Section: Historical Management Of Resectable Oropharyngeal Carcinomamentioning

confidence: 99%

Transoral robotic surgery and a paradigm shift in the management of oropharyngeal squamous cell carcinoma

2010

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“…Division of the soft tissue structures medial to che body of the hemimandible on the side of the mouth to which access is required allows it to rotate laterally in the axis of the ascending ramus with the temporomandibular joint at its upper extremity-the "mandibular swing" approach to the mouth (Spiro et al, 1981). With completion of the tumor resection, continuity of the mandibular body is restored by fixing the bone ends together.…”

Section: Surgical Approach To the Oral Cavitymentioning

confidence: 99%

Anatomical factors in the surgery of oral cancer

McGregor

1991

Clinical Anatomy

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Anatomical factors which play a major role in the clinical behaviour of cancers of the tongue, floor of mouth and lower alveolus, dentate and edentulous, are described, the manner in which tumor reaches and invades the mandible, and spreads both locally in the medullary cavity and perineurally along the inferior alveolar nerve. The influence of anatomical factors in the surgical approach to these tumors is also discussed.

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“…The inferior margin of the tumor was 6 cm below the outer surface of the middle cranial base, which could not be accessed via the transcranial route. The mandibular swing approach, which is one of the standard methods to access the anterior part of the parapharyngeal space, 1,19) was effective to remove the lower part of the tumor. These results indicate that the transcervical approach is essential to manipulate the anterior inferior part of the parapharyngeal space.…”

Section: Surgical Strategy For Infratemporal Fossa Tumorsmentioning

confidence: 99%

Surgical Strategy for Tumors Located in or Extending From the Intracranial Space to the Infratemporal Fossa -Advantages of the Transcranial Approach (Zygomatic Infratemporal Fossa Approach) and the Indications for a Combined Transcranial and Transcervical Approach-

Yoshida¹,

Kawase²,

Tomita

et al. 2009

Neurol. Med. Chir.(Tokyo)

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The surgical strategy for tumors located in or extending from the intracranial space to the infratemporal fossa was analyzed in 12 cases with various pathologies. A case of mandibular nerve schwannoma, which extended 1 cm below the external orifice of the foramen ovale, was completely removed via the epidural subtemporal approach without zygomatic osteotomy with partial removal of the middle cranial base. The inferior margin of infratemporal tumor could be accessed via the transcranial route with zygomatic or orbitozygomatic osteotomy without complications including facial nerve injury in nine cases, and the lowest level of the infratemporal tumors was approximately 4.5 cm below the outer surface of the middle cranial base. In five of these 9 cases (2 schwannomas, 1 myxoma, 1 chondrosarcoma, and 1 malignant peripheral nerve sheath tumor), the tumors were localized in the infratemporal fossa, and in the other 4 cases (2 meningiomas, 1 glioblastoma, and 1 ameloblastoma), the tumors extended to both the intracranial space and the infratemporal fossa. In two cases (recurrent jugular schwannoma and mandibular osteosarcoma), a combined transcranial and transcervical approach (mandibular swing approach) was essential, because the resection line of the lower margin was too far from the middle cranial base. These results indicate that the transcranial approach, with or without zygomatic or orbitozygomatic osteotomy (zygomatic infratemporal fossa approach), is safe and effective for removal of some infratemporal tumors, and that a combined transcranial and transcervical approach is useful for removing infratemporal tumors with extensive downward extension.

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Mandibular “swing” approach for oral and oropharyngeal tumors

Cited by 142 publications

References 2 publications

Transoral robotic surgery and a paradigm shift in the management of oropharyngeal squamous cell carcinoma

Transoral robotic surgery and a paradigm shift in the management of oropharyngeal squamous cell carcinoma

Anatomical factors in the surgery of oral cancer

Surgical Strategy for Tumors Located in or Extending From the Intracranial Space to the Infratemporal Fossa -Advantages of the Transcranial Approach (Zygomatic Infratemporal Fossa Approach) and the Indications for a Combined Transcranial and Transcervical Approach-

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