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Endoscopic Endonasal Approach to the Pterygopalatine Fossa and Infratemporal Fossa: Comparison of the Prelacrimal and Denker's Corridors

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机构: [1]Department of Otolaryngology-Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China [2]Department of Otolaryngology-Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, USA [3]Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA [4]Department of Neurological Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, USA
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关键词: infratemporal fossa pterygopalatine fossa prelacrimal approach Denker's approach exposure surgical freedom

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Background Both the endoscopic transnasal Denker's and prelacrimal approaches provide surgical access to the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). Objectives This study compares the potential maximum exposure of the PPF and ITF and quantifies the difference in surgical freedom via endoscopic Denker's and prelacrimal approaches. Methods Six cadaveric specimens (12 sides) were dissected using a prelacrimal approach on one side and an endoscopic Denker's approach on the contralateral side. The contents of the PPF and ITF were sequentially exposed. Surgical freedom for each corridor was subsequently calculated. Results This study confirms that both the prelacrimal and Denker's approaches provide adequate exposure of the PPF and ITF. The maximum exposure boundaries were similar for both approaches, including the middle cranial fossa superiorly, floor of the maxillary sinus inferiorly, zygomatic arch and temporomandibular joint laterally, and post-styloid space posteriorly. However, the data revealed a statistically significant difference (p < 0.05) regarding the surgical freedom of the prelacrimal (388.17 +/- 32.86 mm(2)) and the endoscopic Denker's approaches (906.35 +/- 38.38 mm(2)). Conclusion When compared with an endoscopic Denker's approach, a prelacrimal approach seems to achieve a similar extent of exposure (ie, visualization) of the PPF and ITF. Nonetheless, the endoscopic Denker's approach offers superior surgical freedom; thus, it is preferred for the management of complex lesions which requires increased instrument maneuverability with a 3- or 4-handed technique.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 3 区 耳鼻喉科学
最新[2023]版:
大类 | 3 区 医学
小类 | 2 区 耳鼻喉科学
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出版当年[2020]版:
Q2 OTORHINOLARYNGOLOGY
最新[2023]版:
Q1 OTORHINOLARYNGOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Department of Otolaryngology-Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China [2]Department of Otolaryngology-Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, USA
通讯作者:
通讯机构: [2]Department of Otolaryngology-Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, USA [4]Department of Neurological Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, USA [*1]Department of Otolaryngology-Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, USA [*2]Department of Neurological Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, USA
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