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Anatomy based corridors to the infratemporal fossa: Implications for endoscopic approaches

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机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Ohio State Univ, James Canc Hosp, Wexner Med Ctr, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA [3]Johns Hopkins Sch Med, Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA [4]Natl Inst Deafness & Other Commun Disorders, Div Otolaryngol Head & Neck Surg, NIH, Bethesda, MD USA [5]Ohio State Univ, James Canc Hosp, Wexner Med Ctr, Dept Neurol Surg, Columbus, OH 43210 USA
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关键词: endoscopic Denker's approach infratemporal fossa muscles of mastication pterygoid muscle transpterygoid

摘要:
Background The infratemporal fossa (ITF) represents an area densely packed with neurovascular structures within irregular boundaries. The goal of this study was to classify the ITF into zones corresponding to its anatomical spaces and the order in which they are encountered during an endonasal approach (anteroposterior axis). Methods Six cadaveric specimens (12 sides) with injected colored latex were dissected. Following an endoscopic medial maxillectomy and Denker's approach, a progressive exploration of the masticator space and upper parapharyngeal space was completed. A classification of the ITF based on well-defined spaces was ascertained. Results The ITF was divided into five zones: Zone 1 (retromaxillary space)-space lying between the posterolateral wall of the maxillary sinus and the temporalis and pterygoid muscles. Zone 2 (superior interpterygoid space)-area including the superior head of the lateral pterygoid muscle, V-3, and foramen ovale. Zone 3 (inferior interpterygoid space)-includes the inferior head of lateral pterygoid muscle, medial pterygoid, and temporalis muscles, and the space enclosed by these muscles. Zone 4 (temporo-masseteric space)-space lateral to the temporalis muscle (comprising fat mostly). Zone 5 (tubopharyngeal space)-includes the Eustachian tube, tensor, and levator veli palatini muscles, and structures in upper parapharyngeal space. Conclusion The ITF can be visualized as five zones based on spaces enclosed by the masticator muscles and upper parapharyngeal structures. This novel classification system is useful to guide endoscopic approaches to the ITF, while decreasing the potential for injury of neurovascular structures and pterygoid muscles.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 2 区 耳鼻喉科学 3 区 外科
最新[2025]版:
大类 | 3 区 医学
小类 | 2 区 耳鼻喉科学 3 区 外科
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出版当年[2018]版:
Q1 OTORHINOLARYNGOLOGY Q2 SURGERY
最新[2023]版:
Q1 OTORHINOLARYNGOLOGY Q1 SURGERY

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Ohio State Univ, James Canc Hosp, Wexner Med Ctr, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA
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通讯机构: [2]Ohio State Univ, James Canc Hosp, Wexner Med Ctr, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA [5]Ohio State Univ, James Canc Hosp, Wexner Med Ctr, Dept Neurol Surg, Columbus, OH 43210 USA [*1]Ohio State Univ, Comprehens Skull Base Surg Program, Dept Otolaryngol Head & Neck Surg, Dept Neurol Surg,Wexner Med Ctr,James Canc Ctr, Columbus, OH 43210 USA [*2]Ohio State Univ, Wexner Med Ctr, Solove Res Inst, Columbus, OH 43210 USA
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