Mass in the infratemporal fossa

Application of a computer-aided navigation technique in surgery for recurrent malignant infratemporal fossa tumors

BACKGROUND

Because of the complexity of the local anatomy, tumors in the infratemporal fossa present a great challenge to oral and maxillofacial surgeons. Recurrent malignant tumors in this area are particularly difficult and precarious to resect because scars from previous operations may dislocate some important structures.

METHODS

From August 2010 to December 2013, all recurrent cases of malignant infratemporal fossa tumors at Peking University Stomatological Hospital were enrolled in this study. The patients were divided into 2 groups: the navigation group and the nonnavigation group, with different managements. The following factors were evaluated: operation time, bleeding volume, tumor size, surgical approach and complications, follow-up survey, and outcomes.In addition, survival analyses were performed for all patients.

RESULTS

In total, 42 patients were investigated. The mean operation time for the navigation group was not significantly longer than that of the nonnavigation group (283.64 versus 252.10 min, respectively; P = 0.393); the group's mean intraoperative bleeding volumes were similar (536.36 versus 503.87 mL, respectively; P = 0.814). The surgical approach was determined and categorized as an inferior approach (transmandibular approach, with or without splitting of the mandible), anterior approach (transmaxillary approach), lateral approach (subtemporal-preauricular approach), or combined approach. The inferior approach was most frequently used in both groups (ie, 63.6% for the navigation group and 80.6% for the nonnavigation group). The tumors were completely resected in 4 patients from the navigation group and 24 patients from the nonnavigation group. Regarding complications in the navigation and nonnavigation groups, the incidence was not significantly different (27.2% versus 41.9%, respectively; P = 0.485). The 3-year survival for patients in the navigation group was 71.6% compared with 52.9% in the nonnavigation group, with no significant difference. In the survival analysis, no significant factor was determined.

CONCLUSIONS

A computer-aided navigation technique has been successfully introduced to resect infratemporal fossa tumors and was successfully applied to the resection of recurrent malignant tumors. This new technique alone does not determine the outcome of patients with recurrent malignant infratemporal fossa tumors. Although some improvements are necessary, the visible navigation during surgery could increase the accuracy and safety of the operations and enhance surgeon confidence.

Recurrent ameloblastoma in temporal fossa: A diagnostic dilemma

Ameloblastoma is a unique, histologically benign but aggressive neoplasm of the jaws, arising from odontogenic epithelium with potency to cause extensive destruction of jaw bones and infiltration into the surrounding tissues. Recurrences are common after incomplete treatment. Recurrences can occur at difficult sites such as temporal and infratemporal fossa, orbit, anterior cranial base, paranasal sinuses etc. Fine needle aspiration cytology or core biopsy of these recurrent lesions may be misleading. Clinical course and radiological features help immensely in these situations. Good communication between surgeon, radiologist, and pathologist is of paramount importance.

Infratemporal fossa metastasis from carcinoma of the uterine cervix

INTRODUCTION

Carcinoma of the uterine cervix is the fourth commonest malignant tumor in women. The disease spreads into the surrounding tissues by direct infiltration whereas spread by hematogenous dissemination is relatively unusual, and most commonly involves the lung, bone, and liver. The involvement of oral and maxillofacial region is extremely rare in gynecological cancer.

CASE REPORT

In this paper, we present an unusual case of a metastatic squamous cell carcinoma originating in the infratemporal fossa of a 37-year-old woman who had underwent a subtotal hysterectomy, for squamous cell carcinoma of the cervix, 22 months earlier. A whole-body CT scan revealed a mass of enlarged lymph nodes in the mediastinum as well. The patient, who had presented for evaluation of a rapidly increasing trismus associated with deep intermittent facial pain and temporal swelling had initially been treated for a TMJ dysfunction and later for an infratemporal fossa abscess for long before a definite diagnosis was made. A high index of suspicion is possible to make an early diagnosis, which when coupled with an aggressive management can improve survival and quality of life.

Recurrence of ameloblastoma in temporal area: primary treatment influences recurrence rate

Ameloblastomas are benign odontogenic tumors but are locally aggressive, most commonly occurring in the mandible and in the third to fifth decade of life. The male-to-female ratio is approximately equal. Recurrence of ameloblastoma due to inadequate treatment is often described. Recurrences in the temporal area are very rare and are related to the type of primary treatment. The authors describe a case of ameloblastoma recurrence in the temporal area and review the literature regarding recurrence and treatment.

Recurrent unicystic ameloblastoma of the infratemporal and temporal fossa

The ameloblastoma has been described as benign but locally invasive; benign and locally invasive with strong tendency to recur; and locally malignant. Recurrence of this lesion in to the infratemporal and temporal region are rarely reported cases. Complete excision of lesion was done with the help of the advance imaging modalities and possible cause of recurrence in this case is discussed.

Recurrent ameloblastoma of the infratemporal fossa: diagnostic implications and a review of the literature

It is unusual for odontogenic tumours such as ameloblastoma to occur in the infratemporal fossa. Although these odontogenic tumours usually arise in jaws, they can infiltrate into the infratemporal region, pterygomaxillary space or fissure, invading soft tissues by way of extension. A case of recurrent ameloblastoma in the infratemporal fossa region arising from an extension of the lesion from the site of previous occurrence in the right mandibular body is reported.