Endoscopic approach to the infratemporal fossa: anatomic study

Area of Science:

• Neurosurgery
• Head and Neck Surgery
• Endoscopic Surgery

Background:

• Traditional surgical approaches to the infratemporal fossa (ITF) involve significant morbidity.
• Transcranial, transfacial, and transmandibular approaches offer extensive exposure but carry neurological and cosmetic risks.

Purpose of the Study:

• To evaluate the feasibility and extent of exposure using combined endoscopic transmaxillary approaches to the ITF.
• To assess the utility of this combined approach for lesion resection.

Main Methods:

• Endoscopic transmaxillary dissection was performed on 4 cadaver heads.
• Exposure was quantified after endonasal dissection and after adding a Caldwell-Luc approach.
• A case report details the use of this combined approach for trigeminal schwannoma resection.

Main Results:

• The combined endoscopic transmaxillary approach provided visualization of the pterygopalatine fossa and anteromedial ITF.
• Addition of the Caldwell-Luc approach exposed the posterolateral ITF, including critical neurovascular structures.
• The approach was successfully used for trigeminal schwannoma resection.

Conclusions:

• Endoscopic exposure of the infratemporal fossa is feasible.
• Combining endonasal and Caldwell-Luc approaches significantly enhances ITF exposure.
• This technique enables safe and effective resection of ITF lesions.