title: Approach to en bloc resection and reconstruction of primary masticator space malignancies.
abstract: OBJECTIVE
  The aim of this study was to present our experience with management of malignant lesions arising within the masticator space, and to describe a technique of en bloc resection and reconstruction.
  
  
  METHODS
  Case series and case report.
  
  
  METHODS
  Eight cases of masticator space malignancies treated surgically with en bloc resection and free flap reconstruction were retrospectively reviewed.
  
  
  RESULTS
  Tumor extirpation was carried out through a parotidectomy approach with mobilization and protection of the facial nerve. Primary reconstruction was accomplished with vascularized bone containing free flaps, fibula (n = 4), scapula (n = 2), and scapula with latissimus dorsi muscle (n = 2). Mean follow-up was 62.5 months (range, 18-132 months).
  
  
  CONCLUSIONS
  En bloc resection of masticator space malignancies can be consistently accomplished through an extended parotidectomy approach. The defect is best reconstructed with a vascularized bone and soft tissue free flap. Favorable functional and aesthetic outcomes can be successfully achieved using the techniques described in this series.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A.
authors.forename: Jerry
authors.initials: J
authors.lastname: Castro
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A.
authors.forename: Ilya
authors.initials: I
authors.lastname: Likhterov
authors.affiliation: Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, U.S.A.
authors.forename: Saral
authors.initials: S
authors.lastname: Mehra
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A.
authors.forename: Michael
authors.initials: M
authors.lastname: Bassiri-Tehrani
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A.
authors.forename: Sophie
authors.initials: S
authors.lastname: Scherl
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A.
authors.forename: Jason
authors.initials: J
authors.lastname: Clain
authors.affiliation: Department of Oral, Maxillo-Facial Surgery and Otolaryngology, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A.
authors.forename: Daniel
authors.initials: D
authors.lastname: Buchbinder
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel Medical Center, New York, New York, U.S.A.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Urken
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D005360:Fibula / Q000637:transplantation; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps
keywords: Masticator space; infratemporal fossa; mandibulectomy; masticator tumor; temporomandibular reconstruction