Modified double mandibular osteotomy for tumors of the parapharyngeal space.

In 1984, Attia et al described the double mandibular osteotomy as a more direct approach for tumors of the ptergomaxillary and parapharyngeal space. The procedure incorporates the traditional parasymphyseal osteotomy of the mandible with a horizontal osteotomy of the ascending ramus. Several modifications of this technique are described that increase the surgical exposure, while requiring less surgical dissection. The incorporation of rigid fixation with miniplates has improved postoperative recovery by avoiding maxillomandibular fixation and improving oral nutrition.