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The most common approache for the resection of mucoepidermoid carcinoma of the maxilla are the extraoral conventional incision. The standard treatment is en bloc resection with wide safety margins and subsequent reconstruction of the jaw, the resulting scars could be devastating to the patient’s postoperative appearance. In this study we reported endoscopically assisted approach that offers a less aesthetically invasive technique, with complete removal of the lesion. Four patients were included, they were diagnosed of having mucoepidermoid carcinoma by clinical examination, computed tomography imaging in saggittal and coronal planes, and preoperative fine-needle aspiration biopsy. They had endoscopically assisted resections through intranasal approach to resects the upper and the proximal medial extension of the lesion, while the rest had been removed through the trans-palatal route. A pre operative primary acrylic splint was prefabricated to act as a primary obturator. All the resections were successful without recurrence after 2 years follow up. Endoscopically assisted resection of such lesions provides it complete removal with excellent cosmetic results. With this technique there was no facial paralyses, nor recurrences, with excellent aesthetic and functional results. The patients returned back to normal in the short term. It provides a viable alternative to conventional approaches. Key wORDs: Endoscope, mucoepidermoid carcinoma. (956) Yasser Nabil and Alaa Ghita E.D.J. Vol. 62, No. 1 Primary central mucoepidermoid carcinoma of the jaws accounts only for 2±3% of all mucoepidermoid carcinomas reported(2,3). The current standard of care for treatment of malignant jaw tumors is en bloc resection with wide margins to prevent recurrence (4) The majority of these tumors are low-to-intermediate grade which has no positive lymph node involvement, and treatment involves complete resection with negative margins (5,6). The use of endoscope in oral and maxillofacial surgery has become increasingly common in recent years. A popular application is for temporomandibular joint arthroscopy and subcondylar fracture management. It was also used for removal of frontal osteomas, and condylar osteochondroma through an intraoral approach(7,8). Our objective in this prospective clinical study was to assess the outcome of endoscopic-assisted en bloc resection of law grade mucoepidermoid carcinoma of the palate and maxillary sinuses. paTIeNTs aND meThODs Four patients with swelling involving the palate and extended towards the maxillary sinuses. Were selected for this series, which was collected at the Department of Oral and maxillofacial surgery, of the specialized dental teaching Hospital, Cairo, Egypt. The group included 1 man and 3 women aged between 42 and 53 years. They all presented with a nodular well-defined swelling at the hard palate, measuring 2-4 cm Fig. (1). The lesions were progressed slowly. Aspiration was negative. Axial and coronal computed tomographic examination revealed a well defined expansible mass that extended to the maxillary sinus Fig (2). Radiographic examination and a presumptive radio-graphic diagnosis of mucoepidermoid or pleomorphic adenoma. Incisional biopsy was performed under local anesthesia and revealed a low-grade mucoepidermoid carcinoma, histopathological examination revealed neoplastic cells, with an epidermoid and mucoid substances, the cells showed hypercromatism, and nuclear pleomorphism. All patients were given detailed explanation of the procedure and gave full written consent.

TRANSORAL ENDOSCOPIC-ASSISTED EN BLOC RESECTION OF MUCOEPIDERMOID CARCINOMA: AN ALTERNATIVE TO EXTRA-ORAL ROUTE