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. 2008 Jan;18(1):17-27.
doi: 10.1055/s-2007-992765.

Quantitative evaluation of transtemporal and facial translocation approaches to infratemporal fossa

Moni A Kuriakose  1 , Alex Sorin, Rajeev Sharan, Andrew J Fishman, Ramesh Babu, Mark D Delacure
Affiliations

Quantitative evaluation of transtemporal and facial translocation approaches to infratemporal fossa

Moni A Kuriakose et al. Skull Base. 2008 Jan.

Abstract

Objective: To compare the extent of exposure and surgical maneuverability provided by facial translocation and transtemporal approaches for access to the infratemporal fossa and anterolateral skull base.

Materials and methods: Surgical procedures were performed on five fresh frozen adult cadavers (ten sides) with no known pathology. Facial transfacial approaches with and without a mandibulotomy and transtemporal approaches were evaluated. OBJECTIVE measures were (1) the distance from the surgical plane to designated anatomic landmarks and (2) the surgical angle of exposure.

Results: Distances from the surgical plane to the anatomic reference points were comparable for most of the access procedures (3 to 6 cm). The extended midfacial translocation and bilateral facial translocation approaches did, however, provide a shorter operative distance (1 to 3 cm) for access to the infratemporal fossa and contralateral structures, respectively. The transtemporal approaches facilitate a better angle of exposure (74 to 84 degrees) to the petrotemporal region, while the transfacial approaches were superior for access to the infratemporal structures.

Conclusions: Based on the results, we propose a clinical algorithm for selecting a surgical approach based on the position and extent of an infratemporal or petrotemporal lesion.

Keywords: Fisch Type C; Infratemporal fossa; anterior skull base; facial translocation; lateral skull base; transzygomatic approach.

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Figures

Figure 1
Figure 1
(A) Standard facial translocation. The broken line represents an osteotomy at frontonasal, zygomaticofrontal, and zygomaticotemporal sutures. (B) Standard facial translocation approach. The broken line represents an osteotomy at the pterygomaxillary fissure, root of pterygoid, and hard palate.
Figure 2
Figure 2
Transzygomatic approach. The broken line represents the site of the osteotomy.
Figure 3
Figure 3
Infratemporal fossa compartments are divided by an imaginary line drawn from the ipsilateral medial pterygoid plate and glenoid fossa.
See this image and copyright information in PMC

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