In traditional mandibulotomy approach to expose oropharynx, the mandible is split between the lateral incisor and canine teeth (to preserve the genioglossus muscle attachment) and then the mucosal incision runs along the floor of mouth. This can result in devitalization of the incisors as well as injury to lingual and hypoglossal nerves. This can result in poor functional outcome.
In midline labiomandibuloglossotomy approach the oropharynx is exposed without significant morbidity. Since the mandible is split in midline, there is no desensitization of teeth. Tongue is split in midline avascular plane. Therefore, no injury to lingual artery and its branches as well as no injury to sensory and motor nerves. Therefore, the patient is able to speak and swallow without any problem after surgery. Another advantage is that after resecting posterior 1/3 of tongue tumour, reconstruction can be done using the anterior 2/3 of tongue (anterior tongue setback). Tumours involving the posterior 1/3 of tongue, posterior pharyngeal wall and vertebral column from lower clivus to C5 can be exposed with this approach.
