A Modified Retromaxillary Approach to the Infratemporal Fossa: Three Case Studies
JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
2015; 73 (4): 769-780
Familial syndromes associated with intracranial tumours: a review
CHILDS NERVOUS SYSTEM
2014; 30 (1): 47-64
The infratemporal fossa (ITF) is an anatomically complex region with multiple neural and vascular structures entering and exiting through foramina in the skull base. The main obstacles to approaching the ITF are the zygomatic arch, the parotid gland, the facial nerve, and the ascending ramus AND condylar head of the mandible. Different surgical approaches to the ITF exist and the best approach should provide optimal visibility, minimal impairment of temporomandibular joint function, and preservation of motor and sensory nerve integrity. This report describes a modified Obwegeser retromaxillary approach to access lesions within the ITF. A multidisciplinary team was involved, which included an oral and maxillofacial surgery team, a neurosurgery team, and an otolaryngology team. Three patients with large skull base lesions, including an aneurysmal bone cyst, a giant cell tumor of the bone, and an invasive melanoma, underwent resection using this approach and were followed postoperatively. Excellent exposure of the floor of the middle cranial fossa and ITF was achieved with this approach. Functional status remained unchanged with respect to mastication, speech, swallowing, and cosmesis. Given the severity of the patients' conditions and extent of involvement of the skull base, outcomes were favorable, with minimal morbidity. This experience suggests that this approach provides safe access to an anatomically complex region and lessens challenges associated with more conventional approaches.
View details for DOI 10.1016/j.joms.2014.10.025
View details for Web of Science ID 000351240100034
View details for PubMedID 25631866
Most cancers of the central nervous system (CNS) occur sporadically in the absence of any known underlying familial disorder or multi-systemic syndrome. Several syndromes are associated with CNS malignancies, however, and their recognition has significant implications for patient management and prognosis. Patients with syndrome-associated CNS malignancies often have multiple tumours (either confined to one region or distributed throughout the body), with similar or different histology.This review examines syndromes that are strongly associated with CNS cancers: the phakomatosis syndromes, familial syndromes such as Li-Fraumeni and familial polyposis syndromes and dyschondroplasia.
View details for DOI 10.1007/s00381-013-2309-z
View details for Web of Science ID 000329624100006
View details for PubMedID 24193148