Chirurgische zugangswege zum mesopharynx

Because of their localization and their extent, tumours of the deep oral cavity, the oropharynx and the parapharyngeal space are rarely accessible for CO₂ laser dissection. Especially malignant tumours of the base of the tongue and the vallecula as well as salivary gland-related tumours of the parapharyngeal space need wide conventional surgical exposure to allow: resection respecting tumor margins (Ro); oropharyngeal and tongue reconstruction using local and microvascular grafts; prevention of mass-bleeding caused by infectious destruction of large blood vessels. This article reviews the different surgical approaches to oropharyngeal tumours with special reference to "mandibular swing" procedures. Moreover, different graft techniques are critically assessed.