Minimally invasive transnasal and transmaxillary approaches to the pterygopalatine fossa

Squamous cell carcinoma of the pterygopalatine fossa - A case report

“…The pterygopalatine fossa is a narrow, inverted pyramid-shape space situated directly posterior to the maxillary sinus 1,5 . The boundaries of the PPF are complex and are represented by the posterior wall of the maxillary sinus anteriorly, the pterygoid process of the sphenoid bone posteriorly, the pterygomaxillary fissure laterally and the ascending process of the palatine bone medially.…”

“…The superior wall is the greater wing of the sphenoid bone. In the inferior part, the fossa becomes narrow and continues with the palatine canal 1,5,7,8 . Aside from the complex bony structure of the PPF, its contents make it even more difficult to operate.…”

“…Aside from the complex bony structure of the PPF, its contents make it even more difficult to operate. Its contents are represented by important nervous and vascular structures, which pass from the PPF to complex networks of foramina and canals into the surrounding regions 1 . The vascular structures are branches of the maxillary artery and nervous structures are part afferent and efferent fibers of the pterygopalatine ganglion [9][10][11] .…”

“…Both malignant and benign tumors can occur in this space. Most commonly, extensions from nasopharyngeal juvenile angiofibromas or nerve sheath tumors (schwannomas) are found in the PPF 1 …”

“…Traditional surgery for this fossa includes different open-approach techniques, like midfacial degloving, lateral rhinotomy with medial maxillectomy, which have significant postoperative morbidities and sequelae 1 . Modern techniques are described and used due to technological advances in endoscopic surgery, and it is considered that endoscopic-assisted surgery of the PPF can provide better visualization and potentially reduce surgical risks 1,6 . This paper presents the case of a 33-year-old woman who underwent endoscopic surgery for a right PPF tumor.…”