• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.49-53
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• 2015

Ameloblastoma is the most common benign odontogenic tumor, with approximately 80% arising in the mandible and the remainder in the maxilla. However, the infratemporal fossa is a rare site in which ameloblastomas occur. Although malignant transformations or metastasizing processes are extremely rare, tumor recurrence is common, if the tumor is not completely resected. Because reoperation could deteriorate quality of life in the patients and increase surgical morbidity, radical surgery is often recommended to minimize recurrence rates. In this report, we presented our experience of resection of ameloblastoma in the left infratemporal fossa with sufficient safe margin through a lower cheek flap approach and marginal mandibulectomy.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.128-136
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• 1994

Maxillary cancer is usually detected late, and the majority of patients have advanced($T_3\;or\;T_4$) diseases at the first diagnosis. It invades outside the maxillary antrum, superiorly the orbit, ethmoid sinus and the anterior cranial base, anteriorly the facial skin. If the cancer extends through the posterior antral wall, the pterygoid plates, pterygoid muscles and infratemporal fossa are to be involved that make the conventional maxillectomy impossible to remove all the involved structures in infratemporal fossa completely. So, more extensive surgical apprdoach is necessary. We report surgical experience using infratemporal fossa approach(lateral facial approach) in four cases of maxillary cancer and one case of hard palate cancer which extends through the posterior antral wall and involving pterygoid muscles, pterygoid plates and temporalis muscle.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.3.1-3.9
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• 2019

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. Methods: A search of the recent literature using MEDLINE (PubMed), Embase, Cochrane Library, and other online tools was executed using the following keyword combinations: infratemporal fossa, subtemporal fossa, transzygomatic approach, orbitozygomatic approach, transmaxillary approach, facial translocation approach, midface degloving, zygomatico-transmandibular approach, and lateral skull base. Aside from our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) trial, there have been very few randomized controlled trials. The search data for this review are summarized based on the authors' diverse clinical experiences. Results: We divided our results based on representative skull base approaches and the anatomy of the ITF. Basic approaches to the ITF include endoscopic endonasal, transzygomatic, orbitozygomatic, zygomatico-transmandibular, transmaxillary, facial translocation, and the midfacial degloving approach. The borders and inner structures of the ITF (with basic lateral skull base dissection schemes) are summarized, and the modified zygomatico-transmandibular approach (ZTMA) is described in detail. Conclusions: An anatomical basic knowledge would be required for the appropriate management of the ITF pathology for diverse specialized doctors, including maxillofacial, plastic, and vascular surgeons. The ITF approach, in conjunction with the application of microsurgical techniques and improved perioperative care, has permitted significant advances and successful curative outcomes for patients having malignancy in ITF.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.40-45
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• 1999

Objectives: Maxillary cancer is notorious for its poor prognosis because it is usually detected lately and the majority of patients have advanced disease. Especially when the cancer extended to infratemporal fossa or pterygopalatine fossa it is very difficult to remove all the involved structure by conventional maxillectomy. In these cases we have used radical maxillectomy through lateral approach. We tried to figure out the clinical significance of this procedure. Material and Methods: This study retrospectively analyzed 23 patients with squamous cell carcinoma of the maxillary sinus who underwent surgical treatment for cure. Among them 17 patients(group A) were treated with initial surgery and 6 patients(group B) underwent salvage surgery after radiotherpy. Radical maxillectomy was performed in 12 patients and conventional total maxillectomy in 11 patients. Results: In group A, 3 out of 9 total maxillectomy case and none of 8 radical maxillectomy case were recurred. In group B one patient died of postoperative complication and among the other 5 patients only one out of 3 radical maxillectomy was salvaged and 2 total maxillectomy cases were died of intercurrent disease. Conclusion: Wide surgical dissection of pterygopalatine fossa and infratemporal fossa may improve the survival rate in patients with posterior wall invasion of maxillary sinus.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.5
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• pp.307-314
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• 2016

We report a case of retiform hemangioendothelioma (RH) located in the infratemporal fossa and buccal area in a 13-year-old Korean boy. The tumor originated from the sphenoid bone of the infratemporal fossa area and spread into the cavernous sinus, orbital apex, and retro-nasal area with bone destruction of the pterygoid process. Tumor resection was conducted via Le Fort I osteotomy and partial maxillectomy to approach the infratemporal fossa and retro-nasal area. The diagnosis of RH was confirmed after surgery. In the presented patient, surgical excision was incomplete, and close follow-up was performed. There was no evidence of expansion or metastasis of the residual tumor in the 8 years after surgery. In cases of residual RH with low likelihood of expansion and metastasis, even though RH is an intermediate malignancy, close follow-up can be the appropriate treatment choice over additional aggressive therapy. To date, 29 papers and 48 RH cases have been reported, including this case. This case is the second reported RH case presenting as primary bone tumor and the first case originating in the oromaxillofacial area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.2
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• pp.83-86
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• 2014

There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.565-569
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• 2001

A new surgical approach to the area of the infratemporal fossa and parapharyngeal space is described. This approach results in a wide-field exposure of the infratemporal fossa, pterygomaxillary space and parapharyngeal space. We used two osteotomies on the patient's mandible and temporary resection of zygomatic arch for superior margin of tumor. Lower lip splitting was not needed because the incision was started in the frontal scalp, curved in front of and below the external auditary canal, and extended anteriorly to the greater horn of hyoid bone on the neck along a skin crease. We had good results without sacrifice of the facial nerve, mandibular function and sensory supply of the face and oral cavity.

• Investigative Magnetic Resonance Imaging
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• v.21 no.2
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• pp.114-118
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• 2017

Dermoid cysts are benign congenital tumors composed of keratinizing squamous epithelium and dermal derivatives. They account for less than 1% of all intracranial tumors and are rarely exhibited at the base of the skull. To the best of our knowledge, only one case report has presented computed tomography and conventional T1-weighted magnetic resonance (MR) findings that revealed an infratemporal dermoid cyst. In the present study, we report an unusual case of a dermoid cyst in the right infratemporal fossa, which was incidentally detected by MR imaging with the Dixon technique. This article also highlights the importance of meticulous radiological review and the usefulness of the Dixon technique in everyday clinical practice.

• Imaging Science in Dentistry
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• v.34 no.4
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• pp.215-218
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• 2004

Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29-year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.256-259
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• 1997

The fibromatoses are defined as a group of non encapsulated, non metastasizing, fibrous tumors that have a tendency for infiltrative growth and local recurrence following surgical excision and can be divided into fascial and musculoaponeurotic fibromatoses. Infantile fibromatosis is childhood counterpart of musculoaponeurotic fibromatosis and is more common in the head and neck, the shoulder and upper arm and the thigh. Treatment includes excision, radiation, steroid and chemotheraphy, etc. Treatment of choice is complete excision but postoperative deformity and sequelae should be considered. Recently, we have experienced a case of infantile fibromatosis originating from infratemporal fossa and report this case with a review of literatures.