title: An extraoral parapharyngeal space approach via vertical ramus osteotomy.
abstract: BACKGROUND
  Numerous approaches to access the parapharyngeal space have been described, each with associated morbidities.
  
  
  METHODS
  We describe the use of vertical ramus osteotomy to increase exposure of the parapharyngeal space.
  
  
  RESULTS
  We have been using this approach over the past 5 years and have found it to be the preferred approach to the parapharyngeal space.
  
  
  CONCLUSIONS
  This approach provides excellent exposure with low risk to the facial nerve while allowing for adequate tumor resection. It also avoids facial scarring and oral contamination of the cervical wound.
authors.affiliation: Department of Otolaryngology, University of Missouri, Columbia, MO 65202, USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Zitsch
authors.forename: Bart
authors.initials: B
authors.lastname: Patenaude
authors.forename: Taylor
authors.initials: T
authors.lastname: Tidmore
mesh_terms: D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008334:Mandible / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010614:Pharynx / Q000601:surgery*