Double osteotomy of mandibula in the treatment of carotid body tumors with skull base extension Giorgio Prouse, MD, Daniela Mazzaccaro, MD, Fernanda.

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Double osteotomy of mandibula in the treatment of carotid body tumors with skull base extension Giorgio Prouse, MD, Daniela Mazzaccaro, MD, Fernanda Settembrini, MD, Michele Carmo, MD, Federico Biglioli, MD, Piergiorgio G. Settembrini, MD Journal of Vascular Surgery Volume 58, Issue 2, Pages 486-490 (August 2013) DOI: 10.1016/j.jvs.2012.11.086 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 Three-dimensional volume rendering of patients 1 and 2. Left, This image of patient 1 shows a posterior and lateral view of the carotid body tumor and its relation with the mandibula and the skull base. Right, This image of patient 2 is a lateral view of the carotid body chemodectoma (CBC). The small axial image in the lower right corner shows the presence of bilateral CBCs. Journal of Vascular Surgery 2013 58, 486-490DOI: (10.1016/j.jvs.2012.11.086) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 A, Relation between the mandibula angle (blue drawing) and (B) incisions lines drawing of osteotomy subcondylar and mandibular paramediana proximal and distal to inferior alveolar nerve. C, Proximal (clear arrow) and (D) distal mandibular osteotomy (black arrow) with titanium plates. Journal of Vascular Surgery 2013 58, 486-490DOI: (10.1016/j.jvs.2012.11.086) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Drawing with exposure of the internal carotid artery after overturn of mandibula and anterior translation of mandibular condyle. B, Intraoperative image of carotid body chemodectoma (CBC) during the removal. C, Carotid bifurcation without carotid body tumor: the clear arrow indicates the external carotid artery, the black arrow indicates the internal carotid artery, and the asterisk indicates the hypoglossal nerve. D, Postoperative photograph shows the result of the intervention with submandibular scar. Journal of Vascular Surgery 2013 58, 486-490DOI: (10.1016/j.jvs.2012.11.086) Copyright © 2013 Society for Vascular Surgery Terms and Conditions