Endoscopic endonasal approaches to infratemporal fossa tumors: a classification system and case series. Laryngoscope 2014 Nov;124(11):2443-50
Date
12/17/2014Pubmed ID
25513678DOI
10.1002/lary.24638Scopus ID
2-s2.0-84922283915 (requires institutional sign-in at Scopus site) 34 CitationsAbstract
OBJECTIVES/HYPOTHESIS: To propose a clinically applicable anatomic classification system describing three progressive endoscopic endonasal approaches (EEAs) to the infratemporal fossa (ITF) and their potential sequelae. Overall feasibility and outcomes of these approaches are presented through a consecutive case series.
STUDY DESIGN: Description of classification system for EEAs to the ITF and case series.
METHODS: A classification system of EEAs to ITF tumors was created based on the senior author's clinical experience and cadaveric dissection. A retrospective chart review of 21 child and adult patients with primary ITF tumors treated by these approaches from 2008 to 2012 at a tertiary-care academic medical center was conducted.
RESULTS: Three progressive EEAs to ITF tumors were defined: 1) a transpterygopalatine fossa approach, 2) a transmedial pterygoid plate approach, and 3) a translateral pterygoid plate approach. Twenty-one patients treated with these approaches were identified consecutively, with a mean age of 44.2 years (range, 11-79 years). Tumors primarily involving the pterygopalatine fossa and not the ITF were excluded. Pathology included three advanced juvenile nasopharyngeal angiofibromas, three adenoid cystic carcinomas, two recurrent inverted papillomas, two trigeminal schwannomas, and 11 other diverse skull base pathologies. No intraoperative or postoperative complications occurred, with a mean follow-up of 21.5 months (range, 1-55 months). Expected potential sequelae such as V2/palatal numbness, Eustachian tube dysfunction, and trismus occurred in 10/21 patients.
CONCLUSIONS: EEAs to ITF tumors are technically feasible with low risk of complications for well-selected patients. The proposed classification system is useful for anticipating potential sequelae for each approach.
Author List
Taylor RJ, Patel MR, Wheless SA, McKinney KA, Stadler ME, Sasaki-Adams D, Ewend MG, Germanwala AV, Zanation AMAuthor
Michael Stadler MD Associate Dean, Chief Medical Officer, Associate P in the Medical College Physicians Administration department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Angiofibroma
Child
Cohort Studies
Cranial Fossa, Anterior
Endoscopy
Female
Follow-Up Studies
Humans
Infratentorial Neoplasms
Magnetic Resonance Imaging
Male
Middle Aged
Nasal Cavity
Neoplasm Recurrence, Local
Neurilemmoma
Pterygopalatine Fossa
Retrospective Studies
Risk Assessment
Skull Base Neoplasms
Temporal Lobe
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
