Infratemporal Fossa Abscess Managed by Nasal Endoscopic Drainage Using a Navigation System

Area of Science:

• Otorhinolaryngology
• Head and Neck Surgery
• Surgical Anatomy

Background:

• The infratemporal fossa (ITF) is a complex anatomical region containing vital structures.
• Large abscesses in the ITF are rare but necessitate urgent surgical intervention.
• Identifying the exact cause of ITF infections can be challenging.

Purpose of the Study:

• To report a case of a large infratemporal fossa abscess.
• To evaluate the efficacy and safety of a transnasal endoscopic approach for ITF abscess drainage.
• To explore potential etiological factors in immunocompromised individuals.

Main Methods:

• A patient with fever, pain, and trismus was diagnosed with an ITF abscess.
• Surgical drainage was performed using nasal endoscopy with a navigation system.
• Access was achieved through the posterolateral maxillary wall via a small bony window.

Main Results:

• The transnasal endoscopic approach facilitated safe and easy access to the ITF.
• The abscess was successfully drained through a minimally invasive technique.
• The patient's presentation was linked to minimal mucosal thickening without definitive sinusitis, suggesting an atypical cause in an immunocompromised state.

Conclusions:

• Nasal endoscopy combined with navigation provides a safe and effective surgical route for ITF abscess management.
• Minimal mucosal thickening may precipitate ITF abscesses in immunocompromised patients.
• This approach offers a less invasive alternative to traditional open surgeries for ITF pathologies.