Paramedian Madibulotomy

  • A paramedian mandibulotomy:
    • Avoids all the disadvantages of a lateral mandibulotomy and the sequelae of a midline mandibulotomy
  • A paramedian mandibulotomy offers significant advantages:
  • Wide exposure to the surgical field
  • Preservation of the geniohyoid and genioglossus muscles:
    • Leading to preservation of:
      • The hyomandibular complex
  • The only muscle requiring division is the mylohyoid muscle:
    • Which leads to minimal swallowing difficulties
  • A paramedian mandibulotomy does not cause denervation or devascularization of the skin of the chin or the teeth and mandible
  • Fixation at the mandibulotomy site is easy
  • The site of the mandibulotomy does not fall within the lateral portal of radiation therapy if the patient needs postoperative radiotherapy:
    • Thus at present a paramedian mandibulotomy remains an optimal surgical approach for access to posteriorly located larger lesions of the oral cavity and tumors of the oropharynx and parapharyngeal space

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