Infratemporal Fossa Approach to Lesions in the Temporal Bone and Base of the Skull

Jugular Foramen Schwannomas: Surgical Approaches and Outcome of Treatment

“…They include the transmastoid,23 cervicomastoid,20 petro-occipital transsigmoid,17 combined extradural-posterior petrous and suboccipital,24 and the infratemporal approaches. 25 Arenberg and McCreary26 and Neely27 used a suboccipital approach, but many authors have reported that for complete resection, removal of the petrous bone was needed. Gacek23 and Call and Pulec28 reported that for intracranial tumors, the transmastoid approach is better than a posterior fossa craniectomy; potential complications associated with posterior fossa surgery are thus avoided.…”

Surgical management and follow-up of lateral skull base tumors: An 8-year review

“…Owing to the limited visual field of the deep part of the intratemporal fossa area and its relatively large operating distance to the LSB area, in our opinion it is suitable for LSBTs that are mainly derived from the parapharyngeal space. As a classic means of access described by Fisch and Pillsbury (28,29), the transmaxillary approach provides surgeons with a great exposure for the operation. However, this approach may result in vital nerve injury by translocation and dysfunction of the he temporal mandibular joint (TMJ).…”

Swing Mandibulotomy Access to Deep Lobe Parotid Tumors Case Reviews

“…Approximately 10-12% of the parotid tumors arise from the deep lobe with only a small proportion (~1%) with a tendency to extend medially towards the parapharyngeal space (PPS) [1,5,6]. The complex anatomic relations of the deep lobe with adjacent structures often makes tumors involving this lobe and peripheral areas a definite surgical challenge for adequate approach [7,8]. Although recurrent parotid pleomorphic adenomas have been the subject of much attention in the clinical literature, especially, pertaining to managerial issues, there is a relative paucity of information defining the imaging characteristics of these lesions in the radiologic literature [9][10][11][12].…”

“…The histological variation of the tumor along with its particular location poses difficulty in its accessibility for adequate removal of the tumor. Because of the difficulty involved in getting into the parapharyngeal space (PPS), different approaches have been described including the transcervical, the first approach, described by Morfit HM [3], transcervical-transparotid, the most widely used, helpful in PPS tumors originating in the parotid deep lobe, transpalatal or, transoral, described by Ehrlich H [2] and limited to small non-vascular tumors, transmandibular with mandibular osteotomy being described as a complement to the other approaches in order to improve and increase access to the parapharyngeal space (PPS), Ariel IM et al [4] were the first to propose opening the jaw to enter the PPS with numerous variations in the procedure being described later [5,6], and lastly, the orbito-zygomatic approach to the middle cranial fossa described by Fisch U [7] to give access to PPS tumors affecting the temporal bone or, relatively larger tumors reaching the base of skull. Thus, it becomes of utmost significance to select the right surgical approach for such kind of cases balancing maximum exposition and complete and safe removal of the tumor with minimal functional and esthetic morbidity.…”