scholarly journals Tailoring the Optimal Surgical Strategy for the Endoscopic Removal of Juvenile Nasopharyngeal Angiofibromas

2012 ◽  
Vol 4 (3) ◽  
pp. 136-143
Keyword(s):  
Infratemporal Fossa ◽  
Surgical Strategy ◽  
Radiological Assessment ◽  
Endoscopic Removal ◽  
Endoscopic Techniques ◽  
Sphenopalatine Foramen

ABSTRACT Being centered around the sphenopalatine foramen, juvenile nasopharyngeal angiofibromas are notorious for growing toward the infratemporal fossa via the pterygomaxillary fissure. Since, this tumor grows from ‘within’ the sinonasal space, it would be best to surgically follow it from the same path that it took to grow. With the development of endoscopic techniques and instrumentation, endoscopic approaches to the infratemporal fossa have been universally accepted. Nevertheless, since the tumor does not follow a definitive pattern, each surgery needs to be tailored. In the authors’ experience, a preoperative radiological assessment can prove to be a relatively valuable guide to estimate and plan the surgical trajectory that need be taken for this particular tumor. How to cite this article Khattar VS, Hathiram BT. Tailoring the Optimal Surgical Strategy for the Endoscopic Removal of Juvenile Nasopharyngeal Angiofibromas. Int J Otorhinolaryngol Clin 2012;4(3):136-143.

Surgical Strategy for the Tumor Located at or Extending to the Infratemporal Fossa

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Kazunari Yoshida ◽  
Takeshi Kawase
Keyword(s):  
Infratemporal Fossa ◽  
Surgical Strategy

Synchronous pleomorphic adenoma in the infratemporal fossa and contralateral submandibular gland and endoscopic removal

2021 ◽  
Vol 14 (5) ◽  
pp. e237775
Author(s):  
Shahul Hameed Poondiyar Sirajuddin ◽  
Rayappa Chunnusamy
Keyword(s):  
Salivary Glands ◽  
Submandibular Gland ◽  
Pleomorphic Adenoma ◽  
Nasal Septum ◽  
Infratemporal Fossa ◽  
Endoscopic Removal ◽  
Minor Salivary Glands ◽  
Main Stem Bronchus ◽  
Diagnostic Dilemma ◽  
First Case

The objective of this article is to elucidate on our experience with the first case reported in the literature of a synchronous presentation of pleomorphic adenoma (PA) in infratemporal fossa as well as the contralateral submandibular gland. PA most commonly arises from the major salivary glands but has also been reported to arise from minor salivary glands in unusual sites such as the nasal septum, main stem bronchus, trachea, lacrimal gland, external auditory canal, etc. However, it seldom involves the infratemporal fossa and extremely few cases are reported in the literature and coexistent contralateral synchronous PA is nowhere reported in literature. The infratemporal fossa tumour posed a diagnostic dilemma and therapeutic challenge because of its concealed location which we dealt successfully with endoscopic sublabial trans maxillary approach.

scholarly journals Profile of foreign body ingestion and outcomes of endoscopic management in pediatric population

2017 ◽  
Vol 08 (01) ◽  
pp. 17-23
Author(s):  
Avinash Bhat Balekuduru ◽  
Bhuvan Shetty ◽  
Amit Dutta ◽  
Satyaprakash Bonthala Subbaraj
Keyword(s):  
Foreign Body ◽  
Pediatric Population ◽  
Flexible Endoscopy ◽  
Endoscopic Management ◽  
Surgical Removal ◽  
Safe Procedure ◽  
Endoscopic Removal ◽  
Endoscopic Techniques ◽  
Nonsurgical Management ◽  
Gastrointestinal Emergency

Abstract Background: Foreign body (FB) ingestion is a frequent gastrointestinal emergency in pediatric population. Improvement in endoscopic techniques and equipment enables nonsurgical management in most situations. Recent data from India on pediatric FB ingestion have been lacking. Aim: The aim of this study was to assess the profile and outcome after endoscopic management of patients <18 years of age presenting with FB ingestion. Patients and Methods: Records of all the children with FB ingestion who had undergone endoscopic removal at our institution during 5 years (2011–2016) were assessed retrospectively. The nature of FB ingested, and success and complication of endoscopic therapy were analyzed. Results: There were 150 pediatric endoscopies during the study period. Of this, 120 (80%) were for removal of ingested FB. Most common (MC) FB was coin (69%). The retrieved FBs were 83 coins, 13 batteries, 5 pins, 4 clips, 2 each of anklets, keys, marbles, and seeds, one each of spoon, blade, spanner, peanut, toe ring, and a pencil. One had trichobezoar. Esophagus was the MC site of location of FB (85/120). FB removal was successful by flexible endoscopy in 97.1%. Four (0.03%) cases were referred for rigid endoscopic/surgical removal by otolaryngologists/ pediatric surgeon. Except for one child developed bronchopneumonia, there was no morbidity or mortality in the study. Conclusion: Endoscopic removal of FB is a safe procedure with excellent outcomes in a specialized gastroenterology unit.

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.

scholarly journals Surgical Strategy for Tumors Located in or Extending From the Intracranial Space to the Infratemporal Fossa

2009 ◽  
Vol 49 (12) ◽  
pp. 580-586 ◽  
Author(s):  
Kazunari YOSHIDA ◽  
Takeshi KAWASE ◽  
Toshiki TOMITA ◽  
Kaoru OGAWA ◽  
Hiromasa KAWANA ◽  
...  
Keyword(s):  
Infratemporal Fossa ◽  
Surgical Strategy

Transoral endoscopic removal of a bullet from the infratemporal fossa

2008 ◽  
Vol 138 (1) ◽  
pp. 113-114 ◽  
Author(s):  
Laura L. Neff ◽  
Benjamin D. Liess ◽  
C.W. David Chang
Keyword(s):  
Infratemporal Fossa ◽  
Endoscopic Removal

scholarly journals A needle in a haystack: Endoscopic removal of a foreign body from the infratemporal fossa

2018 ◽  
Vol 9 ◽  
pp. 215265671876414 ◽  
Author(s):  
Khrystyna Ioanidis ◽  
Brian Rotenberg
Keyword(s):  
Foreign Body ◽  
Image Guidance ◽  
Foreign Bodies ◽  
Intraoperative Imaging ◽  
Infratemporal Fossa ◽  
Endoscopic Removal ◽  
Dental Procedure ◽  
Open Technique ◽  
Foreign Body Removal ◽  
The Right

Background This report presented the case of a difficult-to-remove needle foreign body. The patient had a dental procedure in which a 30-gauge needle was lost in the gingival buccal sulcus. Several attempts at removal were unsuccessful. The patient presented to the otolaryngology clinic with trismus, pain with mastication, intermittent right otalgia, and numbness of the right cheek. Methods The needle was finally localized in the infratemporal fossa and removed by using image guidance technology. Results This case demonstrated an approach to a difficult-to-locate foreign body removal and the importance of intraoperative imaging in foreign body localization. Conclusion Foreign bodies of the infratemporal fossa and posterior orbit are better removed via endoscopic than open technique.

scholarly journals Bedah sinonasal endoskopik angiofibroma nasofaring belia: laporan seri kasus berbasis bukti (evidence based)

2012 ◽  
Vol 42 (2) ◽  
Author(s):  
Retno Sulistyo Wardani ◽  
Ika Dewi Mayangsari ◽  
Lisnawati L ◽  
Jacub Pandelaki ◽  
Kharisma Prameswari ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Evidence Based ◽  
Alternative Technique ◽  
Endoscopic Removal ◽  
Significant Morbidity ◽  
Nasopharyngeal Angiofibroma ◽  
Sphenopalatine Foramen ◽  
Pterygoid Plate ◽  
The Difference ◽  
Endoscopic Sinonasal Surgery

Background: Juvenile nasopharyngeal angiofibroma (JNA) is a histologically benign, but locally invasive neoplasm occurring most often in adolescent males. These tumors are highly aggressive andare associated with significant morbidity and mortality due to its tendency to bleed. Purpose: To presentevidence based case-report on endoscopic removal of JNA as an alternative technique besides the openapproach. Cases: Three cases of JNA managed endoscopically of their removal and the difference ofclinical symptoms based on the histopathological variation and radiological description analysis, givingbenefits in endoscopic surgical planning. Management: The classical treatment for JNA is surgery,however there are cases in which may indicate radiotherapy or even hormone therapy and gamma knifesurgery. Recent advances in technology enable ENT surgeons to use the endonasal technique as analternative in treating JNA patients. Conclusion: Endoscopic removal of JNA was successfully performedfor T1 and T2 tumor based on Fisch classification. To support a good management for JNA casesendoscopically, carefull considerations should be made to determine accesses toward the predominant attachment of the tumor to sphenopalatine foramen and pterygoid plate. Rhinologists and OncologyHeadandNecksurgeonsshouldhavedeepunderstandingofendoscopicanatomyoflateralnasalwalland mastering the art of four-hand technique of endoscopic sinonasal surgery. Keywords : angiofibroma, endoscopic surgery, sphenopalatine artery, pterygoid plate of sphenoid bone.  Abstrak :  Latar belakang: Angiofibroma nasofaring belia (ANB) merupakan tumor jinak secara histologis,namun bersifat ganas secara lokal yang terjadi terutama pada anak laki-laki usia remaja. Tumor jenis inibersifat sangat agresif dan sering dihubungkan dengan tingginya angka morbiditas dan mortalitas karenakecenderungan tumor yang mudah berdarah. Tujuan: Mempresentasikan 3 kasus dengan diagnosis klinisANB yang dilakukan ekstirpasi secara bedah sinonasal endoskopik. Telaah literatur terstruktur dilakukanuntuk menganalisis keputusan dan aplikasi pemilihan teknik bedah ini. Kasus: Tiga kasus ANB yangtelah dilakukan ekstirpasi dengan bedah endoskopik dianalisis berdasarkan variasi gejala klinis, gambaranhistopatologi dan gambaran radiologiknya yang berguna untuk perencanaan pembedahan sinonasalendoskopik. Penatalaksanaan: Tatalaksana utama ANB adalah dengan pembedahan, namun pada kasuskasustertentudapat dipilih modalitas radioterapi, terapihormon dan pembedahan dengan pisau gamma.KemajuanteknologimemudahkanparaahlibedahTHTuntukmenggunakanpendekatanendoskopisebagaialternatif pendekatan bedah pada pasien ANB.Kesimpulan:Bedah sinonasal endoskopikANBdapatdilakukanuntuktumorberukuranT1danT2berdasarkanklasifikasiFisch.Faktorlainyangharusdiperhatikanuntukkeberhasilantindakanadalahpemahamananatomiendoskopikhidungdansinusparanasal untuk penetapanakses secara sentripetalmenujuperlekatanutamaANBpada foramensfenopalatinadanlempeng pterigoid, serta kerjasama antaraahli Rinologi dengan ahli Bedah KepalaLeherOnkologi dalam teknik bedah sinonasal endoskopik 4 tangan (four-handtechnique). Kata kunci : angiofibroma, bedah endoskopik, arteri sfenopalatina, lempeng pterigoid os sfenoid.

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