Lateral transmandibular approach to the skull base in children - A report of three cases

The choice of surgical approach to tumors of the cranial base in children is determined by strict criteria. These include optimal visibility for the surgeon, a minimum possible impairment of facial skull growth and the preservation of motor and sensory nerve integrity. From 1993 to 1996, 3 children (6 years, 22 month, 8 month) were operated for cranial base tumors via a lateral transmandibular approach. In all these patients preauricular incision with temporal and submandibular extention was performed. After preparation of the mandible an osteotomy was made above the mandibular foramen and the capitulum could be temporarily exarticulated. Now a wide access to the cranial base was provided and the tumors could be resected. It was possible to follow-up two of these children, observing their further development until the present day. Considering the severity of conditions, the patients achieved good results. For tumor surgery the transmandibular approach to the cranial base. Growth impairment of the mandible can be corrected successfully by distraction osteogenesis technique. Keywords: transmandibulärer Zugang, Schädelbasis, Kleinkind, lateral transmandibular approach, skull base surgery, children