552 results match your criteria: "Skull Base Infratemporal Fossa Approach"

Objectives: The parapharyngeal space (PPS) and infratemporal fossa (ITF) present significant challenges for endoscopic skull base surgery due to their complex anatomy and lack of clear bony landmarks. This study aims to propose a systematic compartmentalization of the PPS and ITF, based on key anatomical structures, to optimize surgical planning and approaches.

Methods: To retain a precise bony reference framework, the walls of the maxillary sinus and pterygoid bone were preserved.

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Introduction: The term petrous bone cholesteatoma (PBC) represents a slow-growing epidermal lesion arising from the petrous part of the temporal bone. It is a rare incidence accounting for only 4-9% of all petrous bone lesions. PBC represents a real surgical challenge due to its complex relationship with critical neurovascular structures.

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Objective: With the capacity to provide maximal lesion exposure, the subtemporal preauricular infratemporal (SPI) approach with condylar fossa osteotomy is highly utilized in radical resection of skull base tumors. While this approach requires disruption of the temporomandibular joint (TMJ) for access, the effects of this maneuver are poorly appreciated in neurosurgery. The aim of this study was to assess the morbidity of condylar fossa osteotomies by comparing oral health quality of life (OHQOL) and general health quality of life (GHQOL) outcomes after TMJ-involving and TMJ-sparing skull base approaches.

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Article Synopsis
  • Fibrous dysplasia of the bone is a condition linked to a GNAS mutation that can affect craniofacial bones and impact nearby neurovascular structures; this case presents the first known instance of this condition affecting the jugular foramen, causing blockage of critical brain sinuses.
  • A 33-year-old man experiencing dizziness and occasional swallowing difficulties underwent imaging that revealed a mass in the left jugular foramen, leading to a successful surgical removal of the tumor while preserving his lower cranial nerves.
  • This case underscores the need for awareness of fibrous dysplasia in jugular fossa assessments and emphasizes the importance of surgical expertise in ensuring patient outcomes and preserving nerve function.
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Article Synopsis
  • * Researchers conducted a systematic review of 27 studies involving 545 patients, identifying five main combined approaches: Anterior petrosal, Supra-tentorial, Infratemporal fossa, Retrosigmoid, and Far-lateral suboccipital.
  • * The study found that these approaches, especially the Anterior petrosal, are effective in treating conditions like meningiomas while showing strong surgical outcomes and low complication rates.
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: to identify advanced or "so-called inoperable" cases of tympanojugular paragangliomas (PGLs) and analyze how each case is surgically managed and followed afterward. : a retrospective case series study. Out of 262 type C and D TJPs and more than 10 cases of advanced or so-called inoperable cases, files of 6 patients with a diagnosis of advanced tympanojugular PGLs who were referred to an otology and skull-base center between 1996 and 2021 were reviewed to analyze management and surgical outcomes.

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Article Synopsis
  • The study examined a modified surgical approach for treating jugular foramen paragangliomas while preserving ear structures.
  • Two female patients underwent the new technique, resulting in complete tumor removal, although one faced post-op complications such as infection and hearing loss.
  • The findings suggest that this method is effective for certain patients with tumors in the jugular foramen, particularly those with minimal artery involvement and limited hearing loss.
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Article Synopsis
  • Juvenile nasopharyngeal angiofibroma (JNA) is a benign but aggressive tumor commonly found in adolescent males, presenting symptoms like nosebleeds and nasal blockage over time.
  • Diagnosis often involves clinical evaluations and imaging studies, with preoperative angiography being key for identifying blood supply to reduce surgical bleeding risks.
  • A case study on a young man in his 20s highlighted surgical removal of a large bilateral JNA that extended into the brain, involving embolization and a complex surgical approach, followed by radiation therapy, leading to positive outcomes after 2 years of follow-up.
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Management of Petrous Bone Cholesteatoma: The Gruppo Otologico Experience.

Eur Arch Otorhinolaryngol

October 2024

Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Italy.

Background: The term petrous bone cholesteatoma (PBC) refers to lesions extending deep to the bony labyrinth via superior, inferior, and posterior cell tracts. PBC is a rare incidence accounting for only 4-9% of petrous bone lesions. Lesions of petrous bone represent a real surgical challenge due to its complex relationship with critical neurovascular structures.

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Jugular Foramen Paragangliomas.

Adv Tech Stand Neurosurg

May 2024

Department of Neurosurgery, Mackenzie Evangelical University Hospital, Curitiba, PR, Brazil.

Paragangliomas are the most common tumors at jugular foramen and pose a great surgical challenge. Careful clinical history and physical examination must be performed to adequately evaluate neurological deficits and its chronologic evolution, also to delineate an overview of the patient performance status. Complete imaging evaluation including MRI and CT scans should be performed, and angiography is a must to depict tumor blood supply and sigmoid sinus/internal jugular vein patency.

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[Microanatomical Investigation of the Subtemporal Transtentorial Approach].

Sichuan Da Xue Xue Bao Yi Xue Ban

March 2024

( 242000) Department of Neurosurgery, Xuancheng Central Hospital, Xuancheng 242000, China.

Objective: To study the microanatomic structure of the subtemporal transtentorial approach to the lateral side of the brainstem, and to provide anatomical information that will assist clinicians to perform surgeries on the lateral, circumferential, and petroclival regions of the brainstem.

Methods: Anatomical investigations were conducted on 8 cadaveric head specimens (16 sides) using the infratemporal transtentorial approach. The heads were tilted to one side, with the zygomatic arch at its highest point.

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Article Synopsis
  • The study reviews the surgical management of complex skull base tumors at Zhuhai People's Hospital using advanced image fusion technology from October 2019 to January 2022.
  • Seven cases were analyzed, including various types of tumors, where preoperative multimodal image fusion helped in surgical planning and led to successful gross total resection for all but two cases with minor complications.
  • The findings suggest that using multimodal image fusion and tailored imaging assessment enhances surgical outcomes for complex skull base tumors, emphasizing the importance of personalized treatment strategies.
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Purpose: The endoscopic trans-eustachian approach (ETETA) is a less invasive approach to the infratemporal fossa (ITF), providing superior exposure compared to traditional transcranial approaches. The anatomy of the pharyngotympanic (eustachian) tube and adjacent neurovascular structures is complex and requires in-depth knowledge to safely perform this approach. We present a cadaveric and radiological assessment of critical anatomic considerations for ETETA.

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Anterior endoscopic sublabial transmaxillary access to middle cranial base lesions.

Head Neck

May 2024

Rhinology and Skull Base Surgery Division, Otolaryngology Head Neck Surgery Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Background: Anterior endoscopic access to middle cranial base lesions becomes feasible in the presence of infratemporal fossa (ITF) involvement. Various approaches, including endoscopic endonasal, transoral sublabial, and transorbital methods, have been described for accessing the ITF through a transmaxillary corridor. Among these approaches, endonasal access is the most commonly preferred, while the transorbital approach is a novel technique gaining popularity.

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Article Synopsis
  • * A rare case is presented where a wooden splinter became lodged in this area after a patient experienced an eyelid injury and an orbital floor fracture, with imaging not clearly showing the foreign body.
  • * Rapid surgical exploration is crucial, as unidentified foreign bodies can lead to serious complications, and treatment should be customized based on individual circumstances.
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Article Synopsis
  • - The infratemporal fossa (ITF) poses surgical challenges due to its deep location and complex vascular structures, but a combined surgical approach can allow for effective tumor removal.
  • - A 69-year-old male patient presented with symptoms related to an ITF tumor, which was successfully excised through a combination of surgical techniques without causing damage to surrounding tissues.
  • - The case highlights the advantages of this method, such as improved visibility, sufficient working space for tumor removal, and minimal impact on recovery due to the use of smaller incisions.
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 The endoscopic endonasal transpterygoid approach (EETPA) with or without the addition of the endoscopic-assisted sublabial anterior transmaxillary approach (ESTA) has become increasingly utilized for lesions posterior to the pterygopalatine fossa (PPF), including infratemporal fossa (ITF), lateral recess of the sphenoid sinus, Meckel's cave, petrous apex, and parapharyngeal space. The main goal of this study is to develop an educational resource to learn the steps of the EETPA for trainees.  EETPA and ESTA were performed in 12 specimens by neurosurgery trainees, under supervision from the senior authors.

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[The efficacy and safety analysis of endoscopic resection for infratemporal fossa benign mass].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi

January 2024

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

Article Synopsis
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Background And Objectives: The infratemporal fossa (ITF) is a complex region bounded by the temporal bone, maxilla, sphenoid, pterygoid plates, and mandibular ramus. Containing a high density of neurovascular and musculoskeletal structures, the ITF can house a number of pathologies, and access is challenging. The ITF approach and its variations can be challenging due to complex anatomy and unfamiliarity by many surgeons.

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Pterygopalatine-Infratemporal Fossa Hydatid Cyst Resembling Cystic Tumor.

Indian J Otolaryngol Head Neck Surg

December 2023

Otorhinolaryngology Department, Mersin University Medicine Faculty Hospital, Çiftlikköy, Yenişehir, Mersin, Turkey.

Hydatid cyst is an endemic disease in Mediterranean and Middle Eastern countries, Eastern European countries, East Africa, China, New Zealand, Australia. We aimed to present this educational case, which is endemic in our country and seen in a very rare localization, with the combined surgical approach, within the literature.

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Article Synopsis
  • * A retrospective analysis of 20 patients was conducted, identifying seven anatomical target zones and documenting various pathologies treated, including meningiomas and schwannomas, with most cases aimed at complete tumor removal.
  • * Post-surgery outcomes showed stable or improved vision for 18 patients, while common side effects included temporary diplopia and swelling, which mostly resolved, particularly for those who had preoperative vision issues.
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