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By Charles Staley (Editor), John E. Skandalakis (Editor), Sean Moore William C. Wood (Editor)
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Extra info for Anatomic Basis of Tumor Surgery, 2nd Edition
The foramina of the hard palate provide pathways of extension of malignancy to the nasal cavity through the incisive foramen, and the pterygopalatine fossa through the palatine foramina. Evaluation of tumors of the hard palate and upper alveolus requires radiologic evaluation for possible perineural spread to the skull base. Magnetic resonance imaging (MRI) with gadolinium is useful for this purpose. Although squamous cell carcinoma is the most common malignancy found in the hard palate, minor salivary gland tumors are nearly as frequent.
This upper, thick portion of the fascia suspends the superior constrictor muscle from the skull base. The external surface of the pharyngeal constrictor muscle is covered by the buccopharyngeal fascia, which covers the pharynx at the level of the superior constrictor muscle and fuses below this level with the middle layer of deep cervical fascia, which forms the remainder of the external fascial covering of the pharynx. The superior pharyngeal constrictor muscle originates from the medial pterygoid plate and pterygomandibular raphe anteriorly, its ﬁbers extending posteriorly in a horizontal and slightly superior and inferior direction to insert on the posterior pharyngeal midline raphe.
The remainder of the closure is performed as previously described. 24 Lateral Mandibulotomy Approach to Tonsil Resection Lateral mandibulotomy provides direct access to the posterior oral cavity and oropharynx, including the tonsil, retromolar trigone, base of tongue, soft palate, and posterior pharyngeal wall. It is particularly useful when the tumor approaches the mandible and the possibility exists for the need to perform a segmental mandibulectomy. The disadvantage is that it results in transection of the inferior alveolar nerve, with resultant lower alveolar and chin anesthesia.
Anatomic Basis of Tumor Surgery, 2nd Edition by Charles Staley (Editor), John E. Skandalakis (Editor), Sean Moore William C. Wood (Editor)