Comparison of perioperative indices and postoperative complications between two surgical treatments for benign tumours in the infratemporal parapharyngeal space: Mandibular ascending branch longitudinal osteotomy versus paramedian osteotomy

Abstract Background: This was a retrospective analysis of perioperative indicators and postoperative complications of ascending branch longitudinal osteotomy versus paramedian osteotomy for treating patients with benign tumours. The aim was to provide a reference for the surgical treatment of benign tumours in the infratemporal parapharyngeal space. Methods: Clinical medical records and imaging data for 58 patients with benign tumours in the infratemporal parapharyngeal region admitted to the Oral and Maxillofacial Surgery Department of the General Hospital of Northern Theater Command were collected from November 2010 to June 2023. 28 patients underwent mandibular median osteotomy (Group A) and 30 patients underwent mandibular ascending branch longitudinal osteotomy (Group B) for the treatment of benign tumours. Comparative analysis of intraoperative bleeding, operation time, and postoperative complications between the two groups was conducted using the t test and chi-square test. Results: The intraoperative blood loss and operation time in Group B were significantly lower than those in Group A (p <0.05), and the incidence of postoperative complications such as limited mouth opening, gap infection, and nerve injury was significantly lower than that in Group A (p <0.05). Patients were followed up from June to December. Postoperatively, temporary mouth opening was limited, the reduction in masticatory function gradually returned to the normal level within approximately 1-3 months, and facial nerve damage returned to normal within approximately 3-6 months after surgery. Conclusion: 1. When the tumour is confined to the infratemporal parapharyngeal space, ascending longitudinal osteotomy has the advantages of less intraoperative bleeding, less surgical time and fewer postoperative complications. 2. Paramedian osteotomy is more suitable when a tumour in the infratemporal parapharyngeal region invades the pterygopalatine fossa upwards, grows beyond the trailing edge of the maxilla backwards, or invades the skull base downwards.