Combined biportal unilateral endoscopic endonasal and endoscopic anterior transmaxillary approach for resection of lesions involving the infratemporal fossa.

Abstract

Approaching tumors involving the infratemporal fossa (ITF) is technically challenging due to the complex relationships between several neurovascular structures and the deep-seated location of these lesions. The authors describe in detail a minimally invasive approach to the ITF, consisting on a single-nostril endoscopic endonasal transmaxillary approach aided by an anterior transmaxillary port (EEA-ATMa). Anatomical landmarks and surgical tenets of this approach are highlighted and reviewed with the goal to guarantee successful tumor resection and avoid operative complications. The EEA-ATMa is technically feasible and offers excellent surgical exposure to the anterior and lateral aspect of ITF, without the need of transecting the Vidian nerve or performing a wide septectomy.