Double mandibular osteotomy with coronoidectomy for tumours in the parapharyngeal space

Removal of deep-lobe parotid tumours from the parapharyngeal space is often difficult because of limited surgical access and the critical vascular and neurologic structures nearby. Mandibulotomy, when necessary, is useful for improving wider visibility and control of the vascular bundle and facial nerve, but may cause damage to the inferior dental and lingual nerves. The double mandibular osteotomy with coronoidectomy gives excellent access and avoids damage to these nerves.