Transparotid excision of rhabdomyosarcoma in masseter muscle: A case report

Retromandibular Transparotid Approach for the Treatment of Benign Nontraumatic Conditions of the Mandible. A Retrospective Consecutive Case-Series Study

ABSTRACT

The retromandibular transparotid approach enables the most direct access to the central and posterior part of the mandibular ramus including the condylar region. So far it has not been widely used for the management of benign pathology of the mandible. The purpose of this study was to evaluate the utilization rate of this approach in the nontrauma setting including the determination of suitable indications for this access. In total, 105 patients with 107 retromandibular transparotid approaches performed in the 6.5 years (from May 2014 to November 2020) were evaluated. Patients suffering from nontrauma pathology accounted for 4.7% of all cases. The recurrences of different types of odontogenic cysts and secondary chronic osteomyelitis were surgically managed via this approach with aesthetically acceptable resultant scar achievement and no identified postoperative complications. All lesions resolved and no recurrences occurred during the follow-up 32.0 ± 20.7 months (range 6 to 59 months, median = 26 months). The retromandibular transparotid approach may be considered for the enucleation of benign bone lesions in selected patients. Another type of surgery for the management of benign nontraumatic conditions in an accessible area without requirements for continuity resection and jaw reconstruction may be also suitable for using this approach.

Novel use of the transparotid approach to the mandible for benign pathology

Access to the mandibular ramus can be difficult. There are a number of described methods for accessing the mandibular ramus and condyle, including a transoral or transcutaneous approach. Access via a transoral approach prevents surgical scars but can result in an excessive amount of bone removal from the anterior mandibular ramus. The transparotid approach has been described and commonly used for the management of mandibular trauma. It allows for direct access to the mandibular ramus and condyle with a number of possible complications, including salivary fistula formation, sialocele and facial nerve injury. Despite these risks, this approach is commonly used in the setting of trauma. This case report describes an additional indication, the successful use of the transparotid approach for the management of benign odontogenic pathology.