Combination of a pre-auricular-temporal approach and zygomatic osteotomy is a useful surgical approach for major temporomandibular joint tumours
however, additional approaches may be required to remove tumours expanding under the basal part of the condyle. We describe a patient with a large odontogenic myxofibroma of the basal part of condyle that was excised by a combination of pre-auricular-temporal approach with resection of the zygomatic arch and transoral approach. A 22-year-old man was referred to our department with a painless swelling in the left preauricular area. There was a palpable mass around his left condyle. Computed tomography revealed an infiltrative mass that had expanded to the vicinity of the impacted third molar root apex. The patient had strong cosmetic requirements, and we therefore adopted a combination of pre-auricular-temporal approach with zygomatic osteotomy and transoral approach for resection of the tumour. There was minimal intraoperative bleeding, and no sensory loss in the area innervated by the facial nerve. Histopathological analysis of the excised tumour revealed odontogenic myxofibroma. The scar was located in an inconspicuous area that could be hidden by his hair and in the oral cavity. There were no signs of recurrence or neoplastic transformation 7 years after surgical intervention.