Complications of mandibulotomy: midline versus paramidline.

OBJECTIVE: Mandibulotomy is an important surgical approach to oral cavity and oropharynx. The objective of this study was to evaluate the related complications of 2 common mandibulotomies: midline (osteotomy between 2 central incisors) and paramidline (osteotomy between lateral incisor and canine). STUDY DESIGN: Ninety-six patients who had cancer in the oral cavity or oropharynx had preoperative evaluation of the mandible with panoramic films. Among them, 42 patients underwent mandibulotomies: midline for 19 patients and paramidline for 23. RESULTS: Twenty (47.6%) of 42 patients had mandibulotomy-related complications, including 9 (21.4%) minor complications and 11 (26.2%) major complications. There were 6 (31.6%) major and 4 (21.1%) minor complications in the midline mandibulotomy and both 5 (21.7%) major and minor complications in the paramidline mandibulotomy. CONCLUSION: There was no significant difference in the mandibulotomy-related complication rate between midline and paramidline mandibulotomies. Paramidline mandibulotomy, which preserves the geniohyoid and genioglossus muscles, should be a better function-preserving operation than midline mandibulotomy.

Endoscopic CO2 laser surgery for an atypical carcinoid tumor of the epiglottis masquerading as a supraglottic cyst.

BACKGROUND: Atypical carcinoid tumor is a neuroendocrine tumor; its occurrence in the larynx is uncommon, and clinical manifestations are rare. We report an unusual case of atypical carcinoid tumor of the epiglottis mimicking a supraglottic retention cyst. METHODS: A 44-year-old woman complained of an intermittent globus sensation of the throat of 2 years' duration. A 1.0- x 0.8-cm cystic lesion was found over the tip of the epiglottis. A supraglottic retention cyst was initially diagnosed, and the patient was treated medically. Her symptoms persisted, so we performed a laryngoscopic biopsy, which suggested an atypical carcinoid tumor. RESULTS: Transoral endoscopic CO2 laser surgery and bilateral elective neck dissection were subsequently performed. The 2-year follow-up did not reveal any locoregional recurrence or distant metastasis. CONCLUSIONS: This aggressive neoplasm may cause only a few, unremarkable symptoms and masquerade as a supraglottic cyst. Endoscopic CO2 laser surgery can be used to resect this uncommon tumor, with oncologically sound results and without surgical morbidity.