scholarly journals Transoral (transvestibular-paramandibular) endoscopic approach for benign tumours in the infratemporal fossa

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-227169 ◽  
Author(s):  
Jorge Torres-Gaya ◽  
Miguel Puche-Torres ◽  
Mariano Marqués-Mateo ◽  
Francisco Javier García Callejo
Keyword(s):  
Minimally Invasive ◽  
Infratemporal Fossa ◽  
Transoral Approach ◽  
Endoscopic Approach ◽  
Rapid Access ◽  
Patient Morbidity ◽  
Benign Tumours

We describe a minimally invasive transoral approach to the infratemporal fossa, by means of endoscopy, which facilitates examination and resection of lesions in this area. Furthermore, we outline the technique employed and a case treated with this approach, which permits a rapid access with very low patient morbidity, due to the use of endoscopy and of transoral access, instead of traditional transfacial approaches.

Quantification Analysis of Minimally Invasive Techniques to the Infratemporal Fossa

2020 ◽  
Author(s):  
Moustafa Ali ◽  
Nyall London ◽  
Daniel Prevedello ◽  
Tekin Baglam ◽  
Ray Cho ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Infratemporal Fossa ◽  
Minimally Invasive Techniques ◽  
Quantification Analysis ◽  
Invasive Techniques

Vasopressin secretory sinonasal esthesioneuroblastoma – minimally invasive endoscopic approach (case report)

ORL ro ◽  
2017 ◽  
Vol 3 (36) ◽  
pp. 6
Author(s):  
Bogdan Mocanu ◽  
Simona Jercălău ◽  
Silviu Oprescu ◽  
Alina Ciocâlteu
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Endoscopic Approach

Endoscopic Endonasal Approach to the Pterygopalatine Fossa: Anatomic Study

Neurosurgery ◽  
2003 ◽  
Vol 52 (2) ◽  
pp. 374-380 ◽  
Author(s):  
Alessandra Alfieri ◽  
Hae-Dong Jho ◽  
Raffaele Schettino ◽  
Manfred Tschabitscher
Keyword(s):  
Minimally Invasive ◽  
Infratemporal Fossa ◽  
Lateral View ◽  
Pterygopalatine Fossa ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Anatomic Study ◽  
Endoscopic Endonasal ◽  
Arteries And Veins ◽  
Anatomic Region

Abstract OBJECTIVE The pterygopalatine fossa is a relatively small anatomic region. Because of its rich vasculonervous contents and its connections with several intracranial and extracranial compartments, it is of particular surgical interest. Because of its deep localization and despite its small size, however, it can require extensive anatomic approaches, especially for invasive cranial base lesions. We performed a cadaveric study through a minimally invasive endoscopic endonasal approach to the pterygopalatine fossa. METHODS We studied 16 pterygopalatine fossae in eight adult cadaveric heads in which the arteries and veins were injected with latex. For visualization, we used rod-lens endoscopes, 4 mm in diameter and 18 cm in length, with 0-, 30-, 45-, and 70-degree lenses. An endonasal middle meatal transpalatine approach, an endonasal middle meatal transantral approach, and an endonasal inferior turbinectomy transantral approach were used. RESULTS The middle meatal transpalatine approach allows for medial exposure of the pterygopalatine fossa contents, the middle meatal transantral approach allows a lateral view, and the inferior turbinectomy transantral approach allows the widest view and room for surgical maneuvering in the medial and lateral compartments of the pterygopalatine fossa and the infratemporal fossa. CONCLUSION Our anatomic study shows that this approach can be considered a valid minimally invasive option to approach pterygopalatine fossa lesions.

A Minimally Invasive Full Endoscopic Approach to Tibial Nerve Neurolysis in Diabetic Foot Neuropathy: An Alternative to Open Procedures

2021 ◽  
Vol 148 (3) ◽  
pp. 592-596
Author(s):  
Tetsuji Uemura ◽  
Hidetaka Watanabe ◽  
Tetsu Yanai ◽  
Hiroshige Kawano ◽  
Aya Yoshida ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Diabetic Foot ◽  
Tibial Nerve ◽  
Endoscopic Approach

Comparative Analysis of the Exposure and Surgical Freedom of the Endoscopic Extended Minipterional Craniotomy and the Transorbital Endoscopic Approach to the Anterior and Middle Cranial Fossae

2018 ◽  
Vol 17 (2) ◽  
pp. 174-181 ◽  
Author(s):  
Raywat Noiphithak ◽  
Juan C Yanez-Siller ◽  
Juan M Revuelta Barbero ◽  
Raymond I Cho ◽  
Bradley A Otto ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Standard Deviation ◽  
Minimally Invasive ◽  
Vertical Axis ◽  
Endoscopic Approach ◽  
Extended Version ◽  
Specific Approach ◽  
Significant Difference ◽  
Surgical Application ◽  
The Mean

AbstractBACKGROUNDNumerous minimally invasive approaches to the skull base have been successively developed. Knowledge of the surgical nuances of a specific approach may facilitate approach selection. This study sought to compare the nuances of an extended version of the minipterional craniotomy (EMPT) with those of the transorbital endoscopic approach (TOEA) to the anterior and middle cranial fossae (ACF and MCF, respectively).OBJECTIVETo quantitatively analyze and compare the area of exposure and surgical freedom between EMPT and TOEA to the ACF and MCF.METHODSEMPT and TOEA were carried out in 5 latex-injected cadaveric heads, bilaterally (10 sides). For each approach, the area of exposure, surgical freedom, and angle of attack were obtained with neuronavigation and statistically compared.RESULTSNo significant difference was found between the mean area of exposure of EMPT and TOEA at the ACF and MCF (P = .709 and .317, respectively). The mean exposure area at the ACF was of 13.4 ± 2.6 cm2 (mean ± standard deviation) and 13.0 ± 1.9 cm2 for EMPT and TOEA, respectively. Except for the crista galli, EMPT afforded a larger area of surgical freedom at all targets. EMPT also achieved significantly greater attack angles in vertical axis except to the crista galli. The horizontal attack angles to all targets were similar between approaches.CONCLUSIONEMPT and TOEA offer a comparable area of exposure at the ACF and MCF in the cadaver; however, the instrument maneuverability afforded by EMPT is superior. Further studies are necessary to better define their precise surgical application.

scholarly journals Surgery for Craniovertebral Junction Pathologies: Minimally Invasive Anterior Submandibular Retropharyngeal Key-Hole Approach

2020 ◽  
Author(s):  
Árpád Viola ◽  
István Kozma ◽  
Dávid Süvegh
Keyword(s):  
Minimally Invasive ◽  
Wound Dehiscence ◽  
Craniovertebral Junction ◽  
Transoral Approach ◽  
Velopharyngeal Insufficiency ◽  
Safe Alternative ◽  
Decompressive Laminectomy ◽  
Neurological Improvement ◽  
Second Stage ◽  
Minimally Invasive Surgical

Abstract BackgroundOur objective was to develop a new, minimally invasive surgical technique for the resolution of craniovertebral junction pathologies, which can eliminate the complications of the previous methods, like liquor-leakage, velopharyngeal insufficiency and wound-dehiscence associated with the transoral or lateral approaches.MethodsDuring the first stage of the operation, three patients underwent occipito-cervical dorsal fusion, while the fourth patient received C1-C2 fusion according to Harms. C1-C2 decompressive laminectomy was performed in all four cases. Ventral C1-C2 decompression with microscope assisted minimally invasive anterior submandibular retropharyngeal key-hole approach (MIS ASR) method was performed in the second stage. The MIS ASR similarly to the traditional anterior retropharyngeal surgery – preserves the hard and soft palates, yet can be performed through a 25 mm wide incision with the use of only one retractor.ResultsThe MIS ASR approach was a success in all four cases, there were no intra- and postoperative complications. This method, compared to the transoral approach, provided on average 23% (4.56 cm2 / 6.05 cm2) smaller dural decompression area; nonetheless, the entire pathology could be removed in all cases. After the surgery, all patients have shown significant neurological improvement.ConclusionBased on the outcome of these four cases we think that the MIS ASR approach is a safe alternative to the traditional methods while improving patient safety by reducing the risks of complications.

Analysis of the far-medial transoral endoscopic approach to the infratemporal fossa

2018 ◽  
Vol 128 (10) ◽  
pp. 2273-2281 ◽  
Author(s):  
Hafiz S. Patwa ◽  
Juan C. Yanez-Siller ◽  
Matias Gomez Galarce ◽  
Bradley A. Otto ◽  
Daniel M. Prevedello ◽  
...  
Keyword(s):  
Infratemporal Fossa ◽  
Endoscopic Approach

Endoscopic transorbital approach to the infratemporal fossa and parapharyngeal space: a cadaveric study

2020 ◽  
Vol 133 (6) ◽  
pp. 1948-1959 ◽  
Author(s):  
Mina M. Gerges ◽  
Saniya S. Godil ◽  
Iyan Younus ◽  
Michael Rezk ◽  
Theodore H. Schwartz
Keyword(s):  
Carotid Artery ◽  
Parapharyngeal Space ◽  
Infratemporal Fossa ◽  
Middle Meningeal Artery ◽  
Endoscopic Approach ◽  
Surgical Approaches ◽  
Maxillary Artery ◽  
Lateral Pterygoid Muscle ◽  
Endoscopic Techniques ◽  
Endoscopic Transorbital

OBJECTIVEThe infratemporal fossa (ITF) and parapharyngeal space are anatomical regions that can be challenging to access without the use of complex, cosmetically disfiguring approaches. With advances in endoscopic techniques, a new group of surgical approaches to access the intracranial space through the orbit has been recently referred to as transorbital neuroendoscopic surgery (TONES). The objective of this study was to establish a transorbital endoscopic approach utilizing the inferior orbital fissure (IOF) to gain access to the ITF and parapharyngeal space and provide a detailed endoscopic anatomical description of this approach.METHODSFour cadaveric heads (8 sides) were dissected using a TONES approach through the IOF to reach the ITF and parapharyngeal space, providing stepwise dissection with detailed anatomical findings and a description of each step.RESULTSAn inferior eyelid approach was made with subperiosteal periorbital dissection to the IOF. The zygomatic and greater wing of the sphenoid were drilled, forming the boundaries of the IOF. The upper head of the lateral pterygoid muscle in the ITF and parapharyngeal space was removed, and 7 distinct planes were described, each with its own anatomical contents. The second part of the maxillary artery was mainly found in plane 1 between the temporalis laterally and the lateral pterygoid muscle in plane 2. The branches of the mandibular nerve (V3) and middle meningeal artery (MMA) were identified in plane 3. Plane 4 was formed by the fascia of the medial pterygoid muscle (MTM) and the tensor veli palatini muscle. The prestyloid segment, found in plane 5, was composed mainly of fat and lymph nodes. The parapharyngeal carotid artery in the poststyloid segment, found in plane 7, was identified after laterally dissecting the styloid diaphragm, found in plane 6. V3 and the origin of the levator and tensor veli palatini muscles serve as landmarks for identification of the parapharyngeal carotid artery.CONCLUSIONSThe transorbital endoscopic approach provides excellent access to the ITF and parapharyngeal space compared to previously described complex and morbid transfacial or transcranial approaches. Using the IOF is an important and useful landmark that permits a wide exposure.

S123 – New Approaches to Infratemporal Fossa Foreign Body Removal

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P118-P118
Author(s):  
Andrew R Scott ◽  
Thomas B Dodson ◽  
Michael P Platt ◽  
Ralph B Metson
Keyword(s):  
Minimally Invasive ◽  
Head And Neck ◽  
Foreign Bodies ◽  
Infratemporal Fossa ◽  
Tertiary Care ◽  
Care Facility ◽  
Guidance System ◽  
Invasive Technique ◽  
Hypodermic Needle ◽  
Surgical Removal

Objectives 1) To understand indications for removal of foreign bodies (FB) from the head and neck. 2) To be able to describe the use of new surgical technologies for FB removal from the head and neck region. 3) To understand the clinical applications of a novel, minimally-invasive technique for removal of FB from the infratemporal fossa. Methods A retrospective review of 2 cases of infratemporal fossa foreign bodies, which were referred to a tertiary care facility for management utilizing a novel transoral, endoscopic, image-guided approach. Results Both patients presented with pain and trismus following failed attempts to retrieve foreign bodies–1 broken hypodermic needle and 1 torn cottonoid sponge-through open explorations. Use of endoscopic equipment for visualization and image-guidance system for precise localization enabled both objects to be removed through a transoral approach. Surgical removal resulted in improvement in pain and trismus in both patients who were discharged within 24 hours. Conclusions A new approach is now available for the minimally-invasive retrieval of radio-opaque foreign bodies in the infratemporal fossa, which avoids the need for extensive surgical dissection or an external incision.

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