Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes the...Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes these tumors difficult to diagnose and treat.Bordered laterally by the zygomatic arch and the mandible and medially by the maxilla and the pterygoid process of the sphenoid bone,this area is located beneath the greater wing of the sphenoid bone.It contains significant structures such as the maxillary artery,the venous pterygoid plexus,the mandibular nerve,and the otic ganglion2.展开更多
BACKGROUND Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy.It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa.Here,we presen...BACKGROUND Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy.It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa.Here,we present a case of aggressive mucoepidermoid carcinoma in the infratemporal fossa with neck lymph node metastasis and also discuss diagnostic and treatment strategies.CASE SUMMARY A 39-year-old woman with a mass located in the right submandibular area presented to our department.Physical examination revealed lymphadenopathy on the right submandibular side measuring 2.5 cm×3 cm that was hard and had poor mobility.Results of nasal endoscopy were unremarkable.Ultrasound examination revealed an enlarged lymph node at level II of the right side.Fine needle aspiration cytology of the metastatic lymph node revealed malignant cells with infection.Contrast-enhanced computed tomography revealed an enhancing ill-defined soft tissue mass in the right infratemporal region.Positron emission tomography/computed tomography revealed hyperintensity in the right infratemporal fossa along with lymphadenopathy at level II of the right-side lymph node.The patient underwent extended resection of the primary tumor,and ipsilateral radical neck dissection was also completed.Hematoxylin-eosin staining and immunohistochemistry revealed a high-grade mucoepidermoid carcinoma.No signs and symptoms of recurrence of the neoplasm were present after 20 mo of follow-up.CONCLUSION Positron emission tomography/computed tomography play a key role in primary tumor localization.Furthermore,histopathology and immunohistochemistry play pivotal roles in disease diagnosis.展开更多
Thirteen patients with infratemporal fossamalignancies treated in the Sichuan Cancer Hospitalfrom 1988 to 1993 are reported. All cases were treatedsurgically with combined therapy. The survival rate ofthe patients wit...Thirteen patients with infratemporal fossamalignancies treated in the Sichuan Cancer Hospitalfrom 1988 to 1993 are reported. All cases were treatedsurgically with combined therapy. The survival rate ofthe patients with survival period beyond 2 years was53.8o/o. The survival was associated with the extent ofdissection (P<0.01). The operation value, surgicalapproaches, resection range, stylohamular line and repairare analyzed and discussed. A new surgical approach, amodified stylohamular line and a new surgical conceptfor resection of the infratemporal fossa malignanciesbony boundary of surgery are introduced in detail.展开更多
This article presents a case of low-grade cribriform cystadenocarcinomas(LGCCC),a rare salivary gland tumor manifesting in the infratemporal fossa(ITF).The lesion in this case is unique in its location,histopathology,...This article presents a case of low-grade cribriform cystadenocarcinomas(LGCCC),a rare salivary gland tumor manifesting in the infratemporal fossa(ITF).The lesion in this case is unique in its location,histopathology,and management in that the tumor resection was performed using an exclusively endoscopic,endonasal approach.This case highlights the expanding application of endoscopic skull base techniques to address an indolent,slow-growing malignancy of the ITF.展开更多
Background:The endoscopic transnasal approach has been proven to have advantages on the removal of the tumors in pterygopalatine fossa(PPF)and infratemporal fossa(ITF).Herein,this study aimed to describe a modified ap...Background:The endoscopic transnasal approach has been proven to have advantages on the removal of the tumors in pterygopalatine fossa(PPF)and infratemporal fossa(ITF).Herein,this study aimed to describe a modified approach for resection of the tumors in these areas,both in cadaveric specimen and clinical patients.Methods:The 20 adult cadaveric specimens and five patients with tumors in PPF and ITF were enrolled in this study.For the cadaveric specimens,ten were simulated anterior transmaxillary approach and ten were performed modified endoscopic transnasal transmaxillary approach.The exposure areas were compared between two groups and main anatomic structure were measured.Surgery was operated in the five patients with tumors of PPF and ITF to verify the experience from the anatomy.Perioperative management,intraoperative findings and postoperative complications were recorded and analyzed.Results:The modified endoscopic transnasal transmaxillary approach provided as enough surgical exposure and high operability to the PPF and ITF as the anterior transmaxillary approach did.The diameter of maxillary artery in the PPF was 3.77±0.78 mm(range:2.06-4.82mm),the diameter of middle meningeal artery in the ITF was 2.79±0.61 mm(range:1.54-3.78 mm).Four patients who suffered schwannoma got total removal and one of adenocystic carcinoma got subtotal removal.The main complications were facial numbness and pericoronitis of the wisdom tooth.No permanent complication was found.Conclusions:With the widespread use of neuroendoscopy,the modified endoscopic transnasal transmaxillary approach is feasible and effective for the resection of tumors located in PPF and ITF,which has significant advantages on less trauma and complications to the patients.展开更多
Objectives:To demonstrate three-hundred and sixty degrees of maxillary sinus(MS)surgical approaches using cadaveric dissections,highlighting the step-by-step anatomy of each procedure.Methods:Two latex-injected cadave...Objectives:To demonstrate three-hundred and sixty degrees of maxillary sinus(MS)surgical approaches using cadaveric dissections,highlighting the step-by-step anatomy of each procedure.Methods:Two latex-injected cadaveric specimens were utilized to perform surgical dissections to demonstrate different approaches to the MS.The procedures were documented with macroscopic images and endoscopic pictures.Results:Dissections were performed to approach the MS medially(endoscopic maxillary antrostomy and ethmoidectomy),anteriorly(Caldwell-Luc),superiorly(transconjunctival/transorbital approach),inferiorly(transpalatal approach),and posterolaterally(preauricular hemicoronal approach).Conclusion:A number of approaches have been described to address pathology in the MS.Surgeons should be familiar with indications,limitations,and surgical anatomy from different perspectives to approach the MS.This paper illustrates anatomic approaches to the MS with detailed step-by-step cadaveric dissections and case examples.展开更多
文摘Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes these tumors difficult to diagnose and treat.Bordered laterally by the zygomatic arch and the mandible and medially by the maxilla and the pterygoid process of the sphenoid bone,this area is located beneath the greater wing of the sphenoid bone.It contains significant structures such as the maxillary artery,the venous pterygoid plexus,the mandibular nerve,and the otic ganglion2.
基金the Basic Research Program of Shenzhen Innovation Council of China,No.JCYJ 20180228175511141 and No.SZBC2017023Sanming Project of Medicine in Shenzhen,No.SZSM 201512036(Oral and Maxillofacial Surgery Team,Professor Yu Guangyan,Stomatology Hospital Peking University).
文摘BACKGROUND Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy.It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa.Here,we present a case of aggressive mucoepidermoid carcinoma in the infratemporal fossa with neck lymph node metastasis and also discuss diagnostic and treatment strategies.CASE SUMMARY A 39-year-old woman with a mass located in the right submandibular area presented to our department.Physical examination revealed lymphadenopathy on the right submandibular side measuring 2.5 cm×3 cm that was hard and had poor mobility.Results of nasal endoscopy were unremarkable.Ultrasound examination revealed an enlarged lymph node at level II of the right side.Fine needle aspiration cytology of the metastatic lymph node revealed malignant cells with infection.Contrast-enhanced computed tomography revealed an enhancing ill-defined soft tissue mass in the right infratemporal region.Positron emission tomography/computed tomography revealed hyperintensity in the right infratemporal fossa along with lymphadenopathy at level II of the right-side lymph node.The patient underwent extended resection of the primary tumor,and ipsilateral radical neck dissection was also completed.Hematoxylin-eosin staining and immunohistochemistry revealed a high-grade mucoepidermoid carcinoma.No signs and symptoms of recurrence of the neoplasm were present after 20 mo of follow-up.CONCLUSION Positron emission tomography/computed tomography play a key role in primary tumor localization.Furthermore,histopathology and immunohistochemistry play pivotal roles in disease diagnosis.
文摘Thirteen patients with infratemporal fossamalignancies treated in the Sichuan Cancer Hospitalfrom 1988 to 1993 are reported. All cases were treatedsurgically with combined therapy. The survival rate ofthe patients with survival period beyond 2 years was53.8o/o. The survival was associated with the extent ofdissection (P<0.01). The operation value, surgicalapproaches, resection range, stylohamular line and repairare analyzed and discussed. A new surgical approach, amodified stylohamular line and a new surgical conceptfor resection of the infratemporal fossa malignanciesbony boundary of surgery are introduced in detail.
文摘This article presents a case of low-grade cribriform cystadenocarcinomas(LGCCC),a rare salivary gland tumor manifesting in the infratemporal fossa(ITF).The lesion in this case is unique in its location,histopathology,and management in that the tumor resection was performed using an exclusively endoscopic,endonasal approach.This case highlights the expanding application of endoscopic skull base techniques to address an indolent,slow-growing malignancy of the ITF.
文摘Background:The endoscopic transnasal approach has been proven to have advantages on the removal of the tumors in pterygopalatine fossa(PPF)and infratemporal fossa(ITF).Herein,this study aimed to describe a modified approach for resection of the tumors in these areas,both in cadaveric specimen and clinical patients.Methods:The 20 adult cadaveric specimens and five patients with tumors in PPF and ITF were enrolled in this study.For the cadaveric specimens,ten were simulated anterior transmaxillary approach and ten were performed modified endoscopic transnasal transmaxillary approach.The exposure areas were compared between two groups and main anatomic structure were measured.Surgery was operated in the five patients with tumors of PPF and ITF to verify the experience from the anatomy.Perioperative management,intraoperative findings and postoperative complications were recorded and analyzed.Results:The modified endoscopic transnasal transmaxillary approach provided as enough surgical exposure and high operability to the PPF and ITF as the anterior transmaxillary approach did.The diameter of maxillary artery in the PPF was 3.77±0.78 mm(range:2.06-4.82mm),the diameter of middle meningeal artery in the ITF was 2.79±0.61 mm(range:1.54-3.78 mm).Four patients who suffered schwannoma got total removal and one of adenocystic carcinoma got subtotal removal.The main complications were facial numbness and pericoronitis of the wisdom tooth.No permanent complication was found.Conclusions:With the widespread use of neuroendoscopy,the modified endoscopic transnasal transmaxillary approach is feasible and effective for the resection of tumors located in PPF and ITF,which has significant advantages on less trauma and complications to the patients.
文摘Objectives:To demonstrate three-hundred and sixty degrees of maxillary sinus(MS)surgical approaches using cadaveric dissections,highlighting the step-by-step anatomy of each procedure.Methods:Two latex-injected cadaveric specimens were utilized to perform surgical dissections to demonstrate different approaches to the MS.The procedures were documented with macroscopic images and endoscopic pictures.Results:Dissections were performed to approach the MS medially(endoscopic maxillary antrostomy and ethmoidectomy),anteriorly(Caldwell-Luc),superiorly(transconjunctival/transorbital approach),inferiorly(transpalatal approach),and posterolaterally(preauricular hemicoronal approach).Conclusion:A number of approaches have been described to address pathology in the MS.Surgeons should be familiar with indications,limitations,and surgical anatomy from different perspectives to approach the MS.This paper illustrates anatomic approaches to the MS with detailed step-by-step cadaveric dissections and case examples.
