Access osteotomy for infratemporal tumors: Two case reports

Tumors occurring in the infratemporal region present a surgical challenge and access osteotomies of the facial skeleton is the answer to access these deeply situated, inaccessible tumors of the head and neck. Various approaches have been devised for their better exposure and it is our expertise as maxillofacial surgeons to provide surgical access by transmaxillary, transzygomatic and transmandibular approaches. We followed this concept in our institute and report here two case reports. The first is a 45-year-old female who presented with right facial pain and temporal swelling due to schwannoma in the right infratemporal region extending into middle cranial fossa. This was jointly treated by a team of neurosurgeons, maxillofacial surgeons and ENT surgeons by right temporal craniotomy, right transmandibular and transzygomatic approach. The second is a rare tumor occurring in a 26-year-old male with the chief complaint of right frontal headache and diplopia. The tumor was excised via access through the zygomatic arch and lateral orbital wall; diagnosed later as Rosai Dorfmans disease. No recurrence was seen at follow-up period of 2 years. These approaches help to reduce the surgical morbidity. Thus, oral and maxillofacial surgeons form a vital role in the multidisciplinary approach to provide access to difficult anatomic locations.