Transoral Finger-Retraction for Endonasal Endoscopic Resection of Masseteric and Buccal Space Lesions

Transoral finger-retraction for surgical resection of benign tumors involving masseter muscle and buccal space

The regular treatment of tumors involving masseter muscle and buccal space like accessory parotid pleomorphic adenoma is performed with external approaches including parotidectomy and facelift incision, which require a large flap elevation and leave an external scar. The current study aimed to revisit the clinical features of the benign tumors involving masseter muscle and buccal space in the mid-posterior cheek region and presented a case series of the patients (n = 10) who underwent surgical resection by transoral finger-retraction. The accessory parotid pleomorphic adenoma (n = 4) and hemangioma (n = 3) were a little bit more in this region. We focused on the surgical procedure of very rare masseteric schwannoma, due to the deep localization of the masseteric mass in the intraoral space. Transoral finger-retraction as a supplemental surgical technique was used to allow for the tumor involving the masseteric and buccal spaces to be delivered into the oral cavity for complete resection. The use of a facial nerve monitoring during the surgical dissection was also recommend. Collectively, this report demonstrated the ability to adequately and safely resect tumors involving masseter muscle and buccal space using a transoral approach facilitated by finger retraction, with better cosmetic results and without visible scar formation.