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Endoscopic endonasal approaches to infratemporal fossa tumors: a classification system and case series.

Publication ,  Journal Article
Taylor, RJ; Patel, MR; Wheless, SA; McKinney, KA; Stadler, ME; Sasaki-Adams, D; Ewend, MG; Germanwala, AV; Zanation, AM
Published in: Laryngoscope
November 2014

OBJECTIVES/HYPOTHESIS: To propose a clinically applicable anatomic classification system describing three progressive endoscopic endonasal approaches (EEAs) to the infratemporal fossa (ITF) and their potential sequelae. Overall feasibility and outcomes of these approaches are presented through a consecutive case series. STUDY DESIGN: Description of classification system for EEAs to the ITF and case series. METHODS: A classification system of EEAs to ITF tumors was created based on the senior author's clinical experience and cadaveric dissection. A retrospective chart review of 21 child and adult patients with primary ITF tumors treated by these approaches from 2008 to 2012 at a tertiary-care academic medical center was conducted. RESULTS: Three progressive EEAs to ITF tumors were defined: 1) a transpterygopalatine fossa approach, 2) a transmedial pterygoid plate approach, and 3) a translateral pterygoid plate approach. Twenty-one patients treated with these approaches were identified consecutively, with a mean age of 44.2 years (range, 11-79 years). Tumors primarily involving the pterygopalatine fossa and not the ITF were excluded. Pathology included three advanced juvenile nasopharyngeal angiofibromas, three adenoid cystic carcinomas, two recurrent inverted papillomas, two trigeminal schwannomas, and 11 other diverse skull base pathologies. No intraoperative or postoperative complications occurred, with a mean follow-up of 21.5 months (range, 1-55 months). Expected potential sequelae such as V2/palatal numbness, Eustachian tube dysfunction, and trismus occurred in 10/21 patients. CONCLUSIONS: EEAs to ITF tumors are technically feasible with low risk of complications for well-selected patients. The proposed classification system is useful for anticipating potential sequelae for each approach.

Duke Scholars

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Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

November 2014

Volume

124

Issue

11

Start / End Page

2443 / 2450

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Temporal Lobe
  • Skull Base Neoplasms
  • Risk Assessment
  • Retrospective Studies
  • Pterygopalatine Fossa
  • Otorhinolaryngology
  • Neurilemmoma
 

Citation

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ICMJE
MLA
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Taylor, R. J., Patel, M. R., Wheless, S. A., McKinney, K. A., Stadler, M. E., Sasaki-Adams, D., … Zanation, A. M. (2014). Endoscopic endonasal approaches to infratemporal fossa tumors: a classification system and case series. Laryngoscope, 124(11), 2443–2450. https://doi.org/10.1002/lary.24638
Taylor, Robert J., Mihir R. Patel, Stephen A. Wheless, Kibwei A. McKinney, Michael E. Stadler, Deanna Sasaki-Adams, Matthew G. Ewend, Anand V. Germanwala, and Adam M. Zanation. “Endoscopic endonasal approaches to infratemporal fossa tumors: a classification system and case series.Laryngoscope 124, no. 11 (November 2014): 2443–50. https://doi.org/10.1002/lary.24638.
Taylor RJ, Patel MR, Wheless SA, McKinney KA, Stadler ME, Sasaki-Adams D, et al. Endoscopic endonasal approaches to infratemporal fossa tumors: a classification system and case series. Laryngoscope. 2014 Nov;124(11):2443–50.
Taylor, Robert J., et al. “Endoscopic endonasal approaches to infratemporal fossa tumors: a classification system and case series.Laryngoscope, vol. 124, no. 11, Nov. 2014, pp. 2443–50. Pubmed, doi:10.1002/lary.24638.
Taylor RJ, Patel MR, Wheless SA, McKinney KA, Stadler ME, Sasaki-Adams D, Ewend MG, Germanwala AV, Zanation AM. Endoscopic endonasal approaches to infratemporal fossa tumors: a classification system and case series. Laryngoscope. 2014 Nov;124(11):2443–2450.
Journal cover image

Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

November 2014

Volume

124

Issue

11

Start / End Page

2443 / 2450

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Temporal Lobe
  • Skull Base Neoplasms
  • Risk Assessment
  • Retrospective Studies
  • Pterygopalatine Fossa
  • Otorhinolaryngology
  • Neurilemmoma