Excision of Obstructing Retropharyngeal Tumor in an Infant:  Excision by Sagittal Jaw-Splitting Approach

The choice of a surgical approach to the pharynx depends upon the location and size of the lesion under consideration. If primarily located in the oropharynx, a direct transoral approach is usually adequate. The nasopharynx may also be reached through an intraoral approach with or without a softpalate-splitting incision or removal of part of the posterior bony palate.¹ If this is not adequate, a lateral pharyngotomy with or without a transection at about the angle of the mandible² may yield a good exposure of the nasopharynx. In certain instances a transantral approach through a Caldwell-Luc or Weber-Fergusson incision may be elected. The hypopharynx may be reached by suspension laryngoscopy or through an anterior³ or lateral pharyngotomy exposure. Very extensive lesions in these areas, especially those that require complete extirpation with a maximum of safety, challenge the effectiveness of any of these surgical approaches. A situation of this