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Resection of skull base lesions has always been riddled with problems like inadequate access, proximity to major vessels, dural tears, cranial nerve damage, and infection. Understanding the modular concept of the facial skeleton has led to the development of transfacial swing osteotomies that facilitates resection in a difficult area with minimal morbidity and excellent cosmetic results. In spite of the current trend toward endonasal endoscopic management of skull base tumors, our series presents nine cases of diverse extensive skull base lesions, 33% of which were recurrent. These cases were approached through different transfacial swing osteotomies through the mandible, a midfacial swing, or a zygomaticotemporal osteotomy as dictated by the three-dimensional spatial location of the lesion, and its extent and proximity to vital structures. Access osteotomies ensured complete removal and good results through the most direct and safe route and good vascular control. This reiterated the fact that transfacial approaches still hold a special place in the management of extensive skull base lesions.

Non-Hodgkin's lymphomas constitute 25 to 40% of all lymphomas. The gastrointestinal tract is the most common site followed by the head and neck area. Salivary gland involvement is a very rare entity and is involved in 0.5 to 5% of all cases. Among all the major salivary glands, the parotid gland is commonly involved followed by the submandibular glands. Misdiagnosis often leads to unnecessary diagnostic procedures, which leads to delay in initiation of appropriate treatment. It is often difficult to diagnose the distinction between lymphoma developing primarily in the parotid gland tissue and in the intraparotid lymph nodes. As per the reports, primary tumors of the parotid gland show no characteristic features on diagnostic imaging, reflecting none of their histological findings. We represent a case of a 61-year-old female who presented with painless, gradually increasing mass in the right parotid region. Imaging studies were suggestive of an infiltrative mass lesion involving right the parotid gland. The patient underwent superficial parotidectomy along with the excision of the part of the deep lobe posterior to submandibular gland with facial nerve preservation. Histopathology of the resected specimen shows infiltrates of lymphocytes into the glandular parenchyma destroying its normal lobular organization and disrupting the normal glandular architecture.

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