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Maxillofac Plast Reconstr Surg 2019 Dec 11;41(1). Epub 2019 Jan 11.

2Department of Oral and Maxillofacial Surgery, Dental Research Institute, Clinical Trial Center and Oral Cancer Center, School of Dentistry, Seoul National University, Seoul, South Korea.

Background: The infratemporal fossa (ITF) is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Due to its difficult approach, surgical intervention at the ITF has remained a heavy burden to surgeons. The aim of this article is to review basic skull base approaches and ITF structures and to avoid severe complications based on the accurate surgical knowledge. Read More

J Craniofac Surg 2019 Jan 10. Epub 2019 Jan 10.

Department of Otorhinolaryngology-Head and Neck Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Selecting an appropriate surgical approach for resection of huge skull base tumors involving pterygopalatine and infratemporal fossa is challenging because of their rarity and high possibility of vital anatomical structure injuries. To suggest the guidance of selecting the appropriate approach by analyzing outcomes and satisfactions of known surgical approaches with our previous experience, the authors retrospectively analyzed skull base tumor cases experienced for 24 years, and condensed to 4 well-known surgical approaches: maxillary swing, infratemporal fossa type C, transzygomatic, and a combined transzygomatic-midfacial degloving approach: to review indications, advantages, and limitations of these approaches. Maxillary swing approach was useful in large-sized tumors as it provided wide surgical field; however, inevitable facial scar was the main drawbacks, especially in adolescents. Read More

Auris Nasus Larynx 2019 Jan 6. Epub 2019 Jan 6.

Department of Head and Neck Surgery. Electronic address:

Objective: In the case of deep invasion of an infratemporal fossa (ITF) tumor, surgeons find it difficult to gain sufficient visualization and working space by conventional surgical approaches. To overcome these limitations, we have developed a novel surgical technique, maxillo-orbito-zygomatic (MOZ) approach, by combining partial lateral maxillectomy with the conventional orbito-zygomatic approach.

Methods: A 63-year-old male presented with the fifth recurrent adenoid-cystic carcinoma in the right deep ITF. Read More

J Craniofac Surg 2018 Dec 29. Epub 2018 Dec 29.

Department of Otolaryngology - Head and Neck Surgery.

Lesions involving the masseteric and buccal spaces have traditionally required transoral or transcervical approaches. Herein, the authors describe the successful endonasal endoscopic resection of a juvenile nasopharyngeal angiofibroma (JNA) with significant extension into the masseteric and buccal spaces facilitated by transoral finger retraction. Juvenile nasopharyngeal angiofibromas are hypervascular tumors originating in the pterygopalatine fossa (PPF) with complex relationships to skull base and orbital structures. Read More

World Neurosurg 2018 Dec 3. Epub 2018 Dec 3.

Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, HNS&FDRc, University of Insubria, Varese, Italy.

Background: Endoscopic endonasal transpterygoid approach is emerging as a valid option for treating selected tumors in the infratemporal fossa. Compared to traditional open approaches, the endoscopic endonasal approach (EEA) presents more difficulty in controlling bleeding and less choice in surgical instruments for endoscopic tumor dissection, which is often performed with bipolar forceps or steel dissectors.

Case Description: We describe the use of an ultrasonic scalpel device for performing endoscopic endonasal resection of two rare infratemporal fossa tumors (mature teratoma and hemangiopericytoma), which has not been reported in the literature so far. Read More

J Craniofac Surg 2019 Jan;30(1):137-140

Department of Otolaryngology - Head and Neck Surgery, Endoscopic Sinus Surgery and Skull Base Surgery, Autonomous University of Veracruz, Xalapa, Mexico.

Ligation of the sphenopalatine and posterior nasal arteries is indicated for posterior epistaxis as initial treatment or when conservative measures fail. In some patients, a transnasal approach or its alternative transantral approach are not possible due to tumor filling the nasal corridor, pterygopalatine fossa, or maxillary sinus. Aim of this study was to evaluate feasibility of endoscopically assisted transoral approach for the ligation of the maxillary artery (MA). Read More

World Neurosurg 2019 Feb 22;122:e1482-e1490. Epub 2018 Nov 22.

Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Padova, Italy.

Objective: Large intradural growth of tympanojugular paragangliomas (TJ-PGs) into the cerebellopontine angle is an infrequent condition that can determine an extensive involvement of vessels and brainstem, representing a surgical challenge. The current classifications lack accuracy for defining large intradural TJ-PGs and assessing their operability. This study aims to retrospectively reappraise the management of a large intradural TJ-PGs surgical series, discussing operability criteria, treatment strategies, and resection techniques. Read More

J Maxillofac Oral Surg 2018 Dec 27;17(4):616-624. Epub 2018 Jun 27.

Department of Head and Neck Surgery, Instituto Nacional de Cancerologia, Av. San Fernando #22, Col. Sección XVI, Tlalpan, 14080 Mexico, D.F. Mexico.

Introduction: Among all head and neck tumors, only 0.5% occur in the parapharyngeal space and 80% are benign tumors. Surgery is the cornerstone of treatment. Read More

World Neurosurg 2018 Dec 13;120:e1011-e1016. Epub 2018 Sep 13.

Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Chinese Medical Association Neuroendoscopic Training Base and Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China. Electronic address:

Background: Both the pterygopalatine fossa (PPF) and the infratemporal fossa (ITF) lie outside the midline of the skull base. Lesions in the PPF or ITF include trigeminal schwannoma (trigeminal schwannoma, TS), which originates from the second or third branch of the trigeminal nerve (maxillary nerve or mandibular nerve). Due to their typically deep anatomic location, lesions in the PPF or ITF can be difficult to treat using traditional surgical approaches. Read More

Int Forum Allergy Rhinol 2018 Dec 2;8(12):1454-1458. Epub 2018 Aug 2.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Background: Reconstruction of the clivus and posterior cranial base defects following endoscopic skull-base surgery can be particularly challenging. Commonly, defects in this region are repaired with pedicled mucoperichondrial flaps from the sinonasal cavity. Complex and large defects often require regional or free flaps, particularly when intranasal flaps have been exhausted. Read More

World Neurosurg 2018 Oct 18;118:172-176. Epub 2018 Jul 18.

Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. Electronic address:

Background: Schwannomas that involve the mandibular division of the trigeminal nerve and localize exclusively in the parapharyngeal space (PPS) and infratemporal fossa (ITF) are extremely rare, and a surgical approach to treat such tumors has not been well established.

Case Description: We present our experience in the treatment of a giant trigeminal schwannoma with wide extension in the ITF and PPS using an endoscopic transvestibular transmandibular approach. The clinical and radiologic findings, preoperative planning, advantages of the surgical approach, and clinical outcome are discussed. Read More

J Neurosurg 2018 Jul 1:1-5. Epub 2018 Jul 1.

1Department of Neurosurgery, Clinical Neurosciences Center.

Jugular foramen cavernous hemangiomas are extremely rare vascular malformations, and, to the best of the authors' knowledge, their occurrence as multifocal lesions involving both intra- and extracranial compartments has never been reported before. Here, the authors describe the case of a 60-year-old woman with a complex multifocal jugular foramen cavernous hemangioma. The patient presented with signs and symptoms concerning for jugular foramen syndrome, as well as a right neck mass. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2018 Oct 7;135(5):361-363. Epub 2018 Jun 7.

Institut universitaire de la face et du cou, 31, avenue de Valombrose, 06103 Nice, France.

Introduction: Facial injuries by penetrating foreign body are unusual and require specific multidisciplinary surgical management.

Case Report: This case report concerns a 20-year-old man who experienced a penetrating injury by a piece of wood to the face and describes the surgical approach to remove the wood and repair the injury. The foreign body had penetrated the infratemporal fossa, with an entry wound situated below the right eye and an exit wound in the neck, in contact with the left internal carotid artery. Read More

World Neurosurg 2018 Aug 1;116:305-308. Epub 2018 Jun 1.

Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

Background: Dermoid cysts are rare tumors usually seen in the midline structure of the brain but rarely arise in the petrous apex and cavernous sinus. There have been very few reports of dermoid cysts arising in the infratemporal fossa, with scarce anatomic descriptions. Here we report the case of a patient with a dermoid cyst in the left infratemporal fossa. Read More

J Neurosurg 2018 May 18:1-11. Epub 2018 May 18.

Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona; and.

OBJECTIVE The transpterygoid extension of the endoscopic endonasal approach provides exposure of the petrous apex, Meckel's cave, paraclival area, and the infratemporal fossa. Safe and efficient localization of the lacerum segment of the internal carotid artery (ICA) is a crucial part of such exposure. The aim of this study is to introduce a novel landmark for localization of the lacerum ICA. Read More

J Neurol Surg B Skull Base 2018 Jun 13;79(3):250-256. Epub 2017 Oct 13.

The Head and Neck Center, Rambam Health Care Campus, Haifa, Israel.

 Surgical removal of parapharyngeal space tumors (PPST) poses challenges due to the complex anatomy of the region. PPSTs are routinely resected by a transcervical approach using blind finger dissection. Large PPSTs or those located high at the skull base, often require transmandibular or infratemporal fossa approaches, associated with considerable morbidity. Read More

Oper Neurosurg (Hagerstown) 2019 Jan;16(1):79-85

Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.

Background: The maxillary artery (MA) has been described as a reliable donor for extracranial-intracranial high-flow bypass. Existing techniques to harvest MA require brain retraction and drilling of the middle fossa (with or without a zygomatic osteotomy), carrying the potential risks of venous bleeding, injury to the branches of the maxillary or mandibular nerves, muscular transection, or temporomandibular junction disorders.

Objective: To describe a novel technique to expose the MA without bony drilling and with minimal impact to surrounding structures. Read More

J Neurol Surg Rep 2018 Jan 22;79(1):e9-e13. Epub 2018 Feb 22.

Department of Neurosurgery, NorthShore University Health System, Evanston, Illinois, United States.

In the absence of significant extracranial disease, patients with solitary brain metastases have shown benefit with resection. Brain lesions due to endometrial cancer are uncommon, and the only described skull base involvement is limited to the pituitary gland. We report the case of a 60-year-old female with endometrial cancer who presented with weeks of right cheek pain and numbness that was accompanied by headaches. Read More

J Stomatol Oral Maxillofac Surg 2018 Jun 21;119(3):212-215. Epub 2018 Feb 21.

Department of Otorhinolaryngology and Head and Neck Surgery, 3rd Faculty of Medicine and University Hospital Královské Vinohrady, Charles University in Prague, Prague, Czech Republic.

Ameloblastoma represents the most common epithelial odontogenic tumor. Because of the proximity of the maxillary tumors to the orbit and skull base, it should be managed as radically as possible. Maxillectomy, mainly via the transfacial or transoral approach, represents the most common type of surgical procedure. Read More

J Neurosurg 2018 Jan 1:1-11. Epub 2018 Jan 1.

Departments of1Neurological Surgery and.

OBJECTIVEMultiple approaches have been designed to reach the medial middle fossa (for lesions in Meckel's cave, in particular), but an anterior approach through the greater wing of the sphenoid (transalisphenoid) has not been explored. In this study, the authors sought to assess the feasibility of and define the anatomical landmarks for an endoscopic anterior transmaxillary transalisphenoid (EATT) approach to Meckel's cave and the middle cranial fossa.METHODSEndoscopic dissection was performed on 5 cadaver heads injected intravascularly with colored silicone bilaterally to develop the approach and define surgical landmarks. Read More

World Neurosurg 2018 Apr 31;112:e489-e496. Epub 2018 Jan 31.

Department of Otorhinolaryngology, Head & Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland.

Background: Expanded endoscopic endonasal approaches to the infratemporal fossa (ITF) are increasingly performed owing to improved visualization and less morbidity compared with classic open approaches. Only a few studies in the literature investigated lateral endoscopic access to the ITF. The aim of this study was to examine the ITF with the minimally invasive endoscopically assisted Gillies approach with a trial of its expansion through a double port technique. Read More

Eur Arch Otorhinolaryngol 2018 Mar 19;275(3):735-741. Epub 2018 Jan 19.

Department of Otolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.

Background: The anatomical locations involved in trigeminal schwannomas (TSs) are quite complex. The endoscopic endonasal approach provides a minimal damage access corridor to both anterior and middle skull base for surgery. Given the nerve function recovery and postoperative neurological deterioration varied in different reports, the author demonstrates his surgery tips and the functional outcomes under endoscopic surgery in one single institution. Read More

World Neurosurg 2018 Apr 12;112:e302-e312. Epub 2018 Jan 12.

Department of Neurosurgery, University of Tokyo Hospital, Tokyo, Japan.

Objective: Skull base meningiomas carry a nonnegligible risk of recurrence. In particular, those arising from the sphenoid wings or middle cranial fossa penetrate into extracranial regions, uncommonly showing massive expansion into the craniofacial regions on recurrence. The role of endoscopic endonasal surgery for those intractable lesions remains unclear. Read More

Otol Neurotol 2018 Feb;39(2):e166-e172

Department of Otology and Skull Base Surgery.

Objective: To analyze the outcomes of microsurgically treated jugular paragangliomas with control of bleeding from the inferior petrous sinus.

Study Design: Retrospective patient review.

Setting: A single university hospital. Read More

Otol Neurotol 2018 01;39(1):82-91

Department of Otolaryngology-Head and Neck Surgery.

Objective: To study the indications and outcomes of lateral sphenoidectomy as part of a combined skull base approach in the treatment of tumors involving Meckel's cave (MC) and cavernous sinus (CS).

Study Design: Retrospective patient series.

Setting: Tertiary referral center. Read More

Otol Neurotol 2017 12;38(10):e476-e485

*Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Rome †Faculty of Medicine and Surgery - Azienda Ospedaliera Di-Messina, Messina, Italy.

Objective: 1. To analyze the surgical outcomes in the management of petrous apex cholesterol granulomas (PACG) with a brief literature review.2. Read More

Oper Neurosurg (Hagerstown) 2017 Apr;13(2):246-257

Department of Neurological Surgery, University of California San Francisco, San Francisco, California.

Background: Extracranial-to-intracranial high-flow bypass often requires cranial, cervical, and graft site incisions. The internal maxillary artery (IMA) has been proposed as a donor to decrease invasiveness, but its length is insufficient for direct intracranial bypass. We report interposition of a superficial temporal artery (STA) graft for high-flow IMA to middle cerebral artery (MCA) bypass using a middle fossa approach. Read More

Oper Neurosurg (Hagerstown) 2017 Oct;13(5):614-621

Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Background: In the last decade, endoscopic skull base surgery has significantly developed and generated a plethora of techniques and approaches for access to the cranial ventral floor. However, the exploration for the least-aggressive, maximally efficient approach continues.

Objective: To describe in detail an anatomical study, along with the technical nuances of a novel endoscopic approach to Meckel's Cave (MC) using a lateral transorbital (LTO) route. Read More

Neurol Med Chir (Tokyo) 2017 Oct 25;57(10):534-541. Epub 2017 Aug 25.

Department of Neurosurgery, Pituitary & Endoscopic Surgery Center, Teikyo University School of Medicine.

The authors describe the surgical anatomy for the endoscopic endonasal approach (EEA) to the ventrolateral skull base. The ventrolateral skull base can be divided into two segments: the upper lateral and lower lateral skull base. The upper lateral skull base includes the cavernous sinus and the orbit, while the lower lateral skull base includes the petrous apex, Meckel's cave, parapharyngeal space, infratemporal fossa, etc. Read More

Surg J (N Y) 2016 Jul 10;2(3):e78-e82. Epub 2016 Aug 10.

Department of Neurosurgery, DFV Neuro, São Paulo, Brazil.

 Pigmented villonodular synovitis (PVNS) is a benign but aggressive lesion arising from sinovia. The temporomandibular joint (TMJ) is hardly ever involved.  We describe a case of PVNS arising in the left TMJ involving infratemporal fossa soft tissue and the skull base; we also present the reconstruction. Read More

Clin Anat 2018 Jul 29;31(5):724-733. Epub 2017 Nov 29.

Department of Neurosurgery, Juntendo University, Tokyo, Japan.

The extracranial-intracranial (EC-IC) bypass using the maxillary artery (MA) has been successfully completed using a radial artery (RA) graft but the complicated anatomy and narrow exposure make it difficult. The purpose of this article is to define the microsurgical exposure of the MA through the middle fossa and describe the branches, diameter, and length of the MA available for the EC-IC bypass in the sphenopalatine fossa and anterior part of the infratemporal fossa. 5 cadaveric specimens were dissected bilaterally (10 MA dissections) to define the microsurgical anatomy of the MA through an intracranial approach. Read More

Oper Neurosurg (Hagerstown) 2017 Jun;13(3):367-373

Department of Neurological Surgery, University of California, San Francisco, San Francisco, California.

Background: Surgical access to Meckel's Cave (MC) is challenging due to its deep location and surrounding important neurovascular structures. Currently existing endoscopic endonasal (EE) approaches require dissecting near the internal carotid artery (ICA) or require transposition of the pterygopalatine neurovascular bundle.

Objective: To describe a novel approach to access the anterolateral aspect of the MC using a minimally invasive EE route. Read More

J Maxillofac Oral Surg 2017 Mar 5;16(1):96-100. Epub 2016 Aug 5.

Division of Oral and Maxillofacial Surgery, AFMC, Pune, India.

Introduction: Access osteotomies provide direct exposure to inaccessible areas of the deep part of craniofacial skeleton for treating pathologies involving vital structures. The use of maxillary swing approach for gaining wide access to the nasopharynx, infratemporal fossa, parapharyngeal space, middle fossa of skull base. Though the maxillary swing requires transfacial incision for wide exposure but with careful handling the scar is minimum and this approach can be used in young people. Read More

J Craniofac Surg 2017 Jun;28(4):951-954

Ear Nose and Throat Department, Adana Numune Training and Research Hospital, Adana, Turkey.

Objective: Intracranial dermoid cysts are rare, slow-growing masses of sellar, parasellar regions, and posterior cranial fossa. The symptomatology of these cysts depends on the localization and presence of rupture. The preoperative diagnosis of these cysts by imagining techniques is distinctive as they have characteristic appearances. Read More

Otolaryngol Clin North Am 2017 Apr 3;50(2):301-313. Epub 2017 Feb 3.

Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.

The endoscopic resection of pterygopalatine and infratemporal fossa malignancies allows excellent visualization and manipulation of tissues in an anatomically complex area compared with open approaches. With less approach morbidity, endoscopic endonasal surgery allows an easier recovery and earlier transition to adjuvant radiotherapy. The endoscopic approach is minimal access but rarely minimally invasive. Read More

Head Neck 2017 04 31;39(4):786-790. Epub 2017 Jan 31.

The Head and Neck Center, Department of Otolaryngology - Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel.

Background: Parapharyngeal space tumors (PPSTs) pose exposure challenges; they are routinely resected by the transcervical approach using blunt/blind finger dissection, increasing the risk of tumor spillage and of neurovascular injury. Large PPSTs or those located high at the skull base often require mandibulotomy or an infratemporal fossa approach, baring considerable morbidity.

Methods: The novel minimally invasive approach described, utilizes endoscopic equipment introduced transcervically for circumferential separation of the tumor from the neurovascular structures of the skull base. Read More

Ear Nose Throat J 2016 Dec;95(12):E1-E6

Department of Otorhinolaryngology, Saudi German Hospital Dubai, Hessa St. 331 West, PO Box 391093, Dubai, UAE.

We conducted a retrospective study to analyze the role of the cervical and lateral skull base approaches in the surgical excision of parapharyngeal space (PPS) tumors. Our study population was made up of 34 patients-15 males and 19 females, aged 13 to 73 years (mean: 50.6)-who had presented to us with a PPS tumor during a 9-year period. Read More

Am J Otolaryngol 2017 Mar - Apr;38(2):251-253. Epub 2016 Nov 23.

Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA. Electronic address:

Herein, we present the case of a previously healthy 54year-old female who developed several weeks of unilateral tinnitus and aural fullness. She subsequently underwent unilateral pressure equalization tube placement at an outside institution after exam demonstrated a middle ear effusion, conductive hearing loss and normal nasopharyngoscopy. Ultimately, an MRI revealed an occult mass in the infratemporal fossa (ITF), which was successfully removed via an endoscopic transnasal ITF approach. Read More

Oral Maxillofac Surg 2017 Mar 24;21(1):1-6. Epub 2016 Nov 24.

Center for Dental Medicine Sciences, Department of Oral Radiology, Gülhane Military Medical Academy, Ankara, Turkey.

Aim: The aim of this case report is to present the trans-sinusoidal pathway used to remove a displaced maxillary third molar from the infratemporal fossa and review the English literature regarding the techniques used.

Case Report: A 21-year-old male patient was referred with the findings of an oroantral fistula on the left maxillary vestibular first molar region and slight restriction of mouth opening. The patient underwent a maxillary sinus surgery in order to remove a sinus retention cyst via Caldwell-Luc access in a dental clinic 4 years ago. Read More

Neurochirurgie 2016 Dec 17;62(6):332-335. Epub 2016 Nov 17.

Department of Neurosurgery, hôpital Nord, CHU AP-HM, 13015 Marseille, France. Electronic address:

Background And Importance: Giant cell reparative granuloma is a very rare benign osteolytic lesion. It typically arises in the mandible and rarely involves the skull.

Clinical Presentation: A 25-year-old male was admitted in August 2002 for a painless left preauricular mass of several months duration. Read More

J Neurosurg 2016 11 5;125(5):1171-1186. Epub 2016 Feb 5.

Departments of 1 Neurosurgical Surgery and.

OBJECTIVE The endoscopic endonasal approach (EEA) offers direct access to midline skull base lesions, and the anterior transpetrosal approach (ATPA) stands out as a method for granting entry into the upper and middle clival areas. This study evaluated the feasibility of performing EEA for tumors located in the petroclival region in comparison with ATPA. METHODS On 8 embalmed cadaver heads, EEA to the petroclival region was performed utilizing a 4-mm endoscope with either 0° or 30° lenses, and an ATPA was performed under microscopic visualization. Read More

Laryngoscope 2017 03 19;127(3):556-560. Epub 2016 Sep 19.

Department of Otolaryngology-Head and Neck Surgery, University of Arizona Medical Center, Tucson, Arizona, U.S.A.

Eur Ann Otorhinolaryngol Head Neck Dis 2016 Dec 16;133(6):423-427. Epub 2016 Jul 16.

Service d'ORL-CCF, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France. Electronic address:

Introduction: Skull base meningoencephaloceles are rare congenital malformations. The two cases of transalar transsphenoidal malformation reported here differ from the classical transsphenoidal meningoencephalocele.

Case Reports: Case 1 was a three-and-a-half-year-old boy and case 2 was a 36-year-old man. Read More

J Craniofac Surg 2016 May;27(3):718-20

State University of New York Upstate Medical Center, Syracuse, NY.

The authors present a patient of a neonate with a skull base extragonadal germ cell tumor requiring a modified facial translocation approach for resection. A 1-week-old female presented with right proptosis, eyelid edema, and nasal obstruction. Imaging revealed a 3-cm right-sided skull base mass involving the right maxillary, ethmoid, sphenoid sinuses, orbit, infratemporal fossa, and cavernous sinus via skull base erosion. Read More

J Neurol Surg B Skull Base 2016 Feb 9;77(1):66-74. Epub 2015 Sep 9.

Department of Otolaryngology - Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, United States; Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, United States.

Objective Access to the pterygopalatine and infratemporal fossae presents a significant surgical challenge, owing to their deep-seated location and complex neurovascular anatomy. This study elucidates the benefits of incremental medial maxillectomies to access this region. We compared access to the medial aspect of the infratemporal fossa provided by medial maxillectomy, anteriorly extended medial maxillectomy, endoscopic Denker approach (i. Read More

J Neurosurg 2016 12 4;125(6):1460-1468. Epub 2016 Mar 4.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.

OBJECTIVE Endoscopic transmaxillary approaches (ETMAs) address pathology of the anterolateral skull base, including the cavernous sinus, pterygopalatine fossa, and infratemporal fossa. This anatomically complex region contains branches of the trigeminal nerve and external carotid artery and is in proximity to the internal carotid artery. The authors postulated, on the basis of intraoperative observations, that the infraorbital nerve (ION) is a useful surgical landmark for navigating this region; therefore, they studied the anatomy of the ION and its relationships to critical neurovascular structures and the maxillary nerve (V2) encountered in ETMAs. Read More

J Neurol Surg Rep 2016 Mar 3;77(1):e008-12. Epub 2015 Nov 3.

Department of Otolaryngology, Head and Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Skull Base Division, Otolaryngology, Head and Neck Surgery, University of Western Australia, Murdoch, Western Australia, Australia.

Background Desmoplastic neurotropic melanoma (DNM) is a rare, highly malignant, and locally invasive form of cutaneous melanoma with a tendency for perineural invasion (PNI). Methods We report a case of a 61-year-old man presenting with right-sided trigeminal neuralgia and progressive facial paresis due to the PNI of the intracranial trigeminal nerve and the intraparotid facial nerve from DNM. We also present a review of the literature with six cases of DNM with PNI of the intracranial trigeminal nerve identified. Read More

Ann Vasc Surg 2016 Jul 21;34:268.e5-8. Epub 2016 Feb 21.

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada. Electronic address:

Extracranial carotid artery aneurysms are rare. Treatment options for these lesions include endovascular interventions, such as coiling and stenting, or surgical reconstruction, such as resection and primary reanastomosis, or interposition bypass grafting. In this report, we describe the surgical technique used to perform surgical repair of an internal carotid artery aneurysm extending up to the base of the skull. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015 Nov;50(11):909-14

Email:

Objective: To identify the landmarks of transpterygoid approach and to report its application in a series of cases.

Methods: Two silicon-injected adult cadaveric heads(4 sides) were dissected by performing an endoscopic endonasal transpterygoid approach after CT scanning for imaging guidance. High-quality pictures were obtained. Read More