Abstract
The midline mandibulotomy, a procedure to the parapharyngeal space, is generally preceded by splitting a lower lip. This incision often creates the cosmetic problem of the potoperative scaring in the midline face. Here, we report a procedure to avoid this problem by forming a flap of a lower lip.
The skin incision extends to the contralateral mental foramen over the hyoid bone. After the division of the mental nerve and the mucosal incision along the gingivobuccal gutter, the lower lip, cheek and masseter muscle is elevated as the strap flap (visor-like flap) from the mandible. This flap makes it possible to perform the midline mandibulotomy without split of the lower lip. The oral cavity is then widely exposed by rotating the flap upward as a visor over the upper lip. The parapharyngeal space is opened widely by retracting the mandible latelally and superiorly.
