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Endoscopic anatomical study of the trans-lateral molar approach to the infratemporal fossa

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Abstract

Background

The infratemporal fossa (ITF) is located deep in the skull base. Recently, the endoscopic transoral approach has enabled maxillofacial surgeons to access the ITF using a less invasive approach compared to the traditional transfacial and endonasal endoscopic approaches.

Objective

The present study aims to provide maxillofacial surgeons with new data concerning direct endoscopic measurement and precise anatomical topography features of the endoscopic trans-lateral molar approach to ITF by comparing the endoscopic and regional anatomy of ITF. A clinical case receiving the proposed surgical approach is used to determine the feasibility of this technique.

Method

The anatomical data were obtained by measuring the bone anatomical landmarks and analyzing the CT imaging data using GE’s Advance Windows 4.1 software on 25 subjects (50 sides). Morphological pictures of the regional anatomy and endoscopic anatomy were obtained from 6 (12 sides) adult cadaver heads, and the anatomical features were described. The present study reports the management of one case using the proposed surgical approach.

Results

The proposed surgical approach clearly revealed neurovascular, muscular, and surgical landmarks in the ITF. The surgical case supports the minimally invasive treatment approach, which could rapidly access the ITF and completely excise benign tumors.

Conclusion

The anatomical studies and surgical case presentation helps us understand the spatial relationship of surgical landmarks of the surgical approach to the ITF for the treatment of benign lesions in the deep cranial base area.

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Acknowledgements

Data collection was conducted in The Third Affiliated Hospital, Sun Yat-sen University. The dissection of cadaver heads was performed in the Anatomic Lab of The Third Affiliated Hospital, Sun Yat-sen University. Other works including CT image processing, anatomic measurement, and article writing were conducted in Panyu Central Hospital.

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Author notes

  1. Wei-wei Cai, Yan Zou, Hai-yong He and Qin-tai Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Panyu Central Hospital, Guangzhou, 511400, Guangdong, China

    Wei-wei Cai & Jian-gang Liang

  2. Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, Guangdong, China

    Yan Zou & Zhuang Kang

  3. Department of Neurosurgery, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, 510630, Guangdong, China

    Hai-yong He

  4. Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, 510630, Guangdong, China

    Qin-tai Yang

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  1. Wei-wei Cai
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  2. Yan Zou
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  3. Zhuang Kang
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  4. Jian-gang Liang
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Correspondence to Hai-yong He or Qin-tai Yang.

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Cai, Ww., Zou, Y., Kang, Z. et al. Endoscopic anatomical study of the trans-lateral molar approach to the infratemporal fossa. Eur Arch Otorhinolaryngol 276, 1783–1791 (2019). https://doi.org/10.1007/s00405-019-05409-5

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  • DOI: https://doi.org/10.1007/s00405-019-05409-5

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