Mandibular bilateral sagittal split osteotomy as a treatment approach for upper neck and skull base tumors

The purpose of the study was to present a method for the upper neck and skull base tumor surgery. Bilateral sagittal split osteotomy in the angle area and the traction of the mandibular ramus and body makes it possible to create an additional anatomical corridor for more convenient surgical interventions on the upper neck and the skull base.
Case description. At Step 1, intraoral access and mobilization of the angle, ramus, and body of the mandible were performed. At Step 2, bilateral sagittal split osteotomy was performed, followed by anterior traction of the mandible. At Step 3, the upper neck and skull base tumor was accessed. At Step 4, osteosynthesis of the mandibula was performed. Results. The proposed approach reduces surgical trauma, minimizes the risks of intraoperative complications, and increases the chances of complete tumor resection in the skull base tumors. The presented technique is based on our experience of the deep neck and skull base tumor surgery.
Conclusion. The method of mandibular bilateral sagittal split osteotomy in the surgery of upper neck and skull base tumors increases the rate of complete resections, reduces the surgical trauma, and minimizes the risks of intraoperative complications. The presented method provides fast postoperative rehabilitation and an optimal cosmetic result.
Key words: mandibular bilateral sagittal split osteotomy, head and neck surgery, skull base tumor, upper neck tumor, carotid bifurcation
Conflicts of interest. The author have no conflicts of interest to declare.
Funding. There was no funding for this study