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Skull Base 2008; 18(1): 017-027
DOI: 10.1055/s-2007-992765
ORIGINAL ARTICLE

© Thieme Medical Publishers

Quantitative Evaluation of Transtemporal and Facial Translocation Approaches to Infratemporal Fossa

Moni A. Kuriakose1 , Alex Sorin2 , Rajeev Sharan1 , Andrew J. Fishman3 , Ramesh Babu3 , Mark D. DeLacure2
  • 1Head and Neck Institute, Amrita Institute of Medical Sciences, Kerala, India
  • 2Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York
  • 3Department of Otolaryngology and Neurotology, New York University School of Medicine, New York, New York
Further Information

Publication History

Publication Date:
13 November 2007 (online)

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ABSTRACT

Objective: To compare the extent of exposure and surgical maneuverability provided by facial translocation and transtemporal approaches for access to the infratemporal fossa and anterolateral skull base. Materials and Methods: Surgical procedures were performed on five fresh frozen adult cadavers (ten sides) with no known pathology. Facial transfacial approaches with and without a mandibulotomy and transtemporal approaches were evaluated. Objective measures were (1) the distance from the surgical plane to designated anatomic landmarks and (2) the surgical angle of exposure. Results: Distances from the surgical plane to the anatomic reference points were comparable for most of the access procedures (3 to 6 cm). The extended midfacial translocation and bilateral facial translocation approaches did, however, provide a shorter operative distance (1 to 3 cm) for access to the infratemporal fossa and contralateral structures, respectively. The transtemporal approaches facilitate a better angle of exposure (74 to 84 degrees) to the petrotemporal region, while the transfacial approaches were superior for access to the infratemporal structures. Conclusions: Based on the results, we propose a clinical algorithm for selecting a surgical approach based on the position and extent of an infratemporal or petrotemporal lesion.

KEYWORDS

Infratemporal fossa - anterior skull base - lateral skull base - Fisch Type C - facial translocation - transzygomatic approach

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Moni A KuriakoseM.D. 

Chairman, Head and Neck Institute, Amrita Institute of Medical Sciences

Elamakkara, Cochin, Kerala 682026, India

Email: mak12@nyu.edu

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