Selection of endoscopic approach to tumors located in pterygopalatine fossa and infratemporal fossa

doi:10.19438/j.cjoms.2017.01.006

Abstract

Abstract: PURPOSE: To describe different endoscopic approaches to remove tumors located in the pterygopalatine fossa (PPF) and infratemporal fossa (ITF) and to analyze the indications and outcomes of these surgical techniques in management of tumors localized in these areas. METHODS: Fifty patients with benign and malignant tumors arising in or extending to the PPF and ITF, treated from 2010 to 2014 at Xijing Hospital, Fourth Military Medical University were retrospectively reviewed. Before surgery, the patients underwent CT and MRI examination. According to tumor type and extent of invasion, three kinds of surgical plan and endoscopic approach were designed. The patients were followed up after surgery and the outcomes were assessed. RESULTS: Fifty consecutive patients were included, among them 31 had benign tumors (24 juvenile nasopharyngeal angiofibromas, 5 extracranial trigeminal schwannomas, 2 chordomas), 8 cases of cyst (5 odontogenic cysts, 3 epidermoid or dermoid cysts); 11 had malignant tumors (5 adenoid-cystic carcinomas, 2 malignant ameloblastomas, 2 chondrosarcomas, 1 neurofibrosarcoma and 1 malignant schwannoma). Three kinds of endoscopic approach were applied, including endoscopic endonasal approach in 27 cases, transmaxillary approach in 9 cases and combined endonasal and transmaxillary approach in 14 cases. Postoperatively, 8 patients with malignant tumors received adjuvant treatment. The mean follow-up was 34.3 months (from 6 to 55 months). Three patients were lost to follow-up, two patients with malignant tumor had recurrence, one patient with neurofibrosarcoma had metastasis. All patients with benign tumor and cyst had no recurrence. CONCLUSIONS: Tumors of PPF and ITF are not infrequent. According to tumors type, biological behaviors, we can select different appropriate endoscopic approaches to resect the tumors and reduce injuries and the incidences of complications at the same time.

Key words: Pterygopalatine fossa, Infratemporal fossa, Endoscopic endonasal approach, Transmaxillary approach, Endoscopic prelacrimal recess approach

CLC Number:

R739.8

SHI Zhao-hui, QIAO Li, CHEN Xiao-dong, LI Xiao-yuan, CHEN Fu-quan. Selection of endoscopic approach to tumors located in pterygopalatine fossa and infratemporal fossa[J]. China Journal of Oral and Maxillofacial Surgery, 2017, 15(1): 26-30.

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