Premium
Use of a midline mandibular osteotomy to improve surgical access for transoral robotic resection of the base of tongue in a patient with trismus
Author(s) -
Tay Gerald,
Ferrell Jay,
Andersen Peter
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24851
Subject(s) - trismus , medicine , transoral robotic surgery , osteotomy , mandibular angle , surgery , tongue , dentistry , resection , mandible (arthropod mouthpart) , molar , botany , pathology , biology , genus
Background The utilization of transoral robotic surgery (TORS) in patients with trismus is limited because of poor surgical exposure. Methods This report is about a 46‐year‐old man with a recurrent right base of tongue cancer who had severe postradiation trismus. We performed a midline mandibular osteotomy without a lip split and this resulted in a markedly improved surgical exposure. He underwent a TORS resection of the right base of the tongue with no significant complications. Results The midline mandibular osteotomy significantly improved the surgical exposure and facilitated exposure for TORS in a patient who otherwise would not be able to undergo TORS. Conclusion Utilization of a midline mandibular osteotomy allowed for increased exposure for TORS in a patient with limited mouth opening from postradiation trismus. Postoperative hemorrhage remains a significant concern and appropriate measures to mitigate the catastrophic consequences of this should be considered.