Surgical Approaches for Pterygopalatine and Infratemporal Fossa Lesions

Approaches to pterygopalatine and infratemporal fossa lesions are numerous because they are relatively surgically inaccessible. We report 9 cases of pterygopalatine and infratemporal fossa lesions. We treated 2 subjects with benign schwannoma using transmaxillar sinus and orbitozygomatic approaches. We used resection without facial skin incision, assuming that presurgical intraarterial embolization and navigational use was important in removing tumors safety with minimal invasion. One case involved lower infratemporal fossa adenoma. We used a mandibular swing for en block removal. We treated 3 with recurrent palatal carcinoma using maxillary swing. In 2 with lesions extending laterally to the parapharyngeal space, mandibular swing was added to maxillary swing. We treated 1 with recurrent chordoma in the infratemporal fossa using maxillary swing to preserve postoperative function and facial form. We treated 2 with massive infratemporal fossa tumors using an infratemporal approach. One of these 2 had a massive tumor invading the maxilla, necessitating maxillectomy with a Weber incision. We concluded that surgical approaches with wide access to safety must be used to resect tumors completely in those with malignancies