Abstract: PURPOSE: To assess the reliability and safety of the post submandibular approach together with osteotomy in the vertical ramus outside of the mandibular foramen in treatment of tumors invading parapharyngeal space. METHODS: Ten primary parapharyngeal-space tumors were treated with a post submandibular approach together with osteotomy in the vertical ramus outside the mandibular foramen. Primary lesions were pleomorphic adenoma, schwannoma, Warthin’s tumor, lipoma, chordoma, and adenoid cystic carcinoma. Tumor size ranged from 4 cm×4 cm to 6 cm×8 cm. Patients with malignant tumors who underwent surgical resection also received adjuvant radiotherapy for about 50Gy. RESULTS: All the tumors were removed completely. No patient exhibited any permanent postoperative complication or other dental complications from this surgical approach. One patient had slight transient postoperative facial paralysis, which resolved spontaneously nearly one month. The patients were followed up for 5 to 28 months. No recurrence was encountered. CONCLUSIONS: The post submandibular approach together with osteotomy in the vertical ramus outside of the mandibular foramen for tumors in the parapharyngeal space is reliable and safe.

Key words: Parapharyngeal tumor, Osteotomy, Surgical approach