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Daines BS, Varman R, Cordero J. A Rare Infratemporal Fossa Abscess of the Lateral Pterygoid. Cureus 2022; 14:e25391. [PMID: 35774702 PMCID: PMC9236688 DOI: 10.7759/cureus.25391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 11/05/2022] Open
Abstract
The infratemporal fossa (ITF) contains many critical neurovascular structures and the muscles of mastication. Infections of the ITF are rare and carry significant pathologic implications due to nearby structures. Abscesses of the ITF often occur due to odontogenic spread and present with trismus and facial pain. We present the case of a 26-year-old male with an uncommon ITF abscess of the lateral pterygoid following maxillary wisdom tooth extraction. The abscess resolved following bedside and operative intraoral drainage in addition to intravenous antibiotic therapy. We highlight the rarity of lateral pterygoid abscesses and the importance of distinguishing ITF abscesses from other similarly presenting conditions such as temporomandibular joint dysfunction.
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Affiliation(s)
- Benjamin S Daines
- Department of Otolaryngology - Head and Neck Surgery, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Rahul Varman
- Department of Otolaryngology - Head and Neck Surgery, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Joehassin Cordero
- Department of Otolaryngology - Head and Neck Surgery, Texas Tech University Health Sciences Center, Lubbock, USA
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Endoscopic transvestibular anatomy of the infratemporal fossa and upper parapharyngeal spaces for clinical surgery: a cadaver study. Eur Arch Otorhinolaryngol 2019; 276:1799-1807. [PMID: 30993466 DOI: 10.1007/s00405-019-05410-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/25/2019] [Indexed: 10/27/2022]
Abstract
AIMS To investigate the anatomy of the infratemporal fossa (ITF) and to discuss the practicality of endoscopic transvestibular surgery for an ITF tumor. METHODS Five fresh cadaveric specimens (10 sides) with vascular silicone injection were prepared for endoscopic anatomy. A transvestibular vertical incision was made along the ramus of the mandible, and pivotal nerves, arteries, and muscles were exposed to sculpt the anatomic landmarks of the ITF. RESULTS The endoscopic transvestibular approach exposed the detailed structure of the ITF. The buccinator muscle and the adjoining superior pharyngeal constrictor muscle shaped the paramedian border of the ITF, while the medial pterygoid muscle (MPM) and the lateral pterygoid muscle formed the lateral border. The ITF was delimited by the skull base in the upper margin, and it was proximal to the parapharyngeal space in the inferior part. The inferior alveolar nerve was the first reference point, and the maxillary artery and the lateral pterygoid muscle were also the landmarks of the ITF. The lingual nerve, the eustachian tube (ET), and the middle meningeal artery were also located in the posterior part of the ITF. CONCLUSION The endoscopic transvestibular approach provides a feasible and facile corridor to the ITF. With accurate hemostasis, this approach may provide another option for accessing the ITF for removal of tumors.
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Shenouda K, Yuhan BT, Mir A, Gonik N, Eloy JA, Liu JK, Folbe AJ, Svider PF. Endoscopic Resection of Pediatric Skull Base Tumors: An Evidence-Based Review. J Neurol Surg B Skull Base 2018; 80:527-539. [PMID: 31534896 DOI: 10.1055/s-0038-1676305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 10/13/2018] [Indexed: 10/27/2022] Open
Abstract
Objectives To perform a systematic review examining experiences with endoscopic resection of skull base lesions in the pediatric population, with a focus on outcomes, recurrence, and surgical morbidities. Methods PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science databases were evaluated. Studies were assessed for level of evidence. Bias risk was evaluated using the Cochrane Bias tool, Grades of Recommendation, Assessment, Development and Evaluation (GRADE), and Methodological Index for Non-Randomized Studies (MINORS) criteria. Patient characteristics, pathology, site of primary disease, presenting symptoms, stage, procedure specific details, and complications were evaluated. Results were reported using the Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidelines. Results Ninety-three studies met criteria for inclusion, encompassing 574 patients with skull base tumors. The GRADE and MINORS criteria determined the overall evidence to be moderate quality. The most common benign and malignant pathologies included juvenile nasopharyngeal angiofibromas ( n = 239) and chondrosarcomas ( n = 11) at 41.6 and 1.9%, respectively. Of all juvenile nasopharyngeal angiofibroma tumors, most presented at stage IIIa and IIIb (25.8 and 27.3%, respectively). Nasal obstruction (16.5%) and headache (16.0%) were common symptoms at initial presentation. Surgical approaches included endoscopic endonasal ( n = 193, 41.2%) and endoscopic extended transsphenoidal ( n = 155, 33.1%). Early (< 6 weeks) and late (>6 weeks) complications included cerebrospinal fluid leak ( n = 36, 17.3%) and endocrinopathy ( n = 43, 20.7%). Mean follow-up time was 37 months (0.5-180 months), with 86.5% showing no evidence of disease and 2.1% having died from disease at last follow-up. Conclusion Endoscopic skull base surgery has been shown to be a safe and effective method of treating a variety of pediatric skull base tumors. If appropriately employed, the minimally invasive approach can provide optimal results in the pediatric population.
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Affiliation(s)
- Kerolos Shenouda
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Brian T Yuhan
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States.,Department of Otolaryngology, William Beaumont Hospital, Royal Oak, Michigan, United States
| | - Ahsan Mir
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Nathan Gonik
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States.,Children's Hospital of Michigan, Detroit, Michigan, United States
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Department of Ophthalmology and Visual Science, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - James K Liu
- Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Adam J Folbe
- Department of Otolaryngology, William Beaumont Hospital, Royal Oak, Michigan, United States.,Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States
| | - Peter F Svider
- Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, United States
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Nakaya M, Yoshihara S, Yoshitomi A, Baba S. Endoscopic endonasal excision of nasal chondromesenchymal hamartoma with intracranial extension. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:423-425. [PMID: 28385583 DOI: 10.1016/j.anorl.2016.05.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 05/23/2016] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Nasal chondromesenchymal hamartoma (NCMH) is an extremely rare benign hamartoma of the sinonasal tract, predominantly involving infants and young children. METHODS We report the case of a 3-year-old boy of NCMH with extension to anterior skull base. RESULTS The tumor was completely resected piece by piece via an endonasal endoscopic approach. There is no recurrence 3 years after operation. CONCLUSIONS We reported the case of NCMH extending to skull base was successfully resected by endonasal endoscopic approach.
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Affiliation(s)
- M Nakaya
- Department of Otolaryngology-Head and Neck Surgery, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan; Department of Otolaryngology, Tokyo Metropolitan Children's Medical Center, 2-8-29, Musashidai, Fuchu-shi, Tokyo 183-8561, Japan.
| | - S Yoshihara
- Department of Otolaryngology-Head and Neck Surgery, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan; Department of Otolaryngology, Tokyo Metropolitan Children's Medical Center, 2-8-29, Musashidai, Fuchu-shi, Tokyo 183-8561, Japan
| | - A Yoshitomi
- Department of Otolaryngology, Tokyo Metropolitan Children's Medical Center, 2-8-29, Musashidai, Fuchu-shi, Tokyo 183-8561, Japan
| | - S Baba
- Department of Otolaryngology, Tokyo Metropolitan Children's Medical Center, 2-8-29, Musashidai, Fuchu-shi, Tokyo 183-8561, Japan
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