Shahinian H K, Suh R H, Jarrahy R
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles 90048, USA.
Ear Nose Throat J. 1999 May;78(5):350, 353-6.
Massive tumors of the infratemporal and pterygopalatine fossa are usually resected via the Fisch type C infratemporal fossa approach. This approach provides the surgeon with wide enough access to safely remove massive tumors, and it allows excellent control of the internal carotid artery without leaving facial scars. The disadvantages of this approach include a total loss of hearing on the affected side and the risk of damage to the facial nerve. The Fisch type D infratemporal preauricular approach provides a limited access to tumors, but it does preserve hearing. We studied the practice of combining the Fisch type D approach with a transfacial, transmaxillary approach. This allows the removal of massive tumors of the area without the necessity of resorting to the type C approach and the resultant loss of hearing and the possibility of facial paralysis. The flexibility of the type D infratemporal fossa approach allows the surgeon to combine it with transmaxillary, transmandibular, and periorbital approaches to remove tumors of all sizes from the infratemporal fossa, pterygopalatine fossa, parapharyngeal space, and orbit.
颞下窝和翼腭窝的巨大肿瘤通常通过 Fisch C 型颞下窝入路进行切除。这种入路为外科医生提供了足够宽的操作空间，以安全地切除巨大肿瘤，并且能够很好地控制颈内动脉，同时不会留下面部瘢痕。该入路的缺点包括患侧听力完全丧失以及面神经损伤的风险。Fisch D 型颞下窝耳前入路对肿瘤的暴露有限，但能保留听力。我们研究了将 Fisch D 型入路与经面部、经上颌入路相结合的方法。这样可以在不采用 C 型入路及其导致的听力丧失和面神经麻痹可能性的情况下，切除该区域的巨大肿瘤。D 型颞下窝入路的灵活性使外科医生能够将其与经上颌、经下颌和眶周入路相结合，以切除来自颞下窝、翼腭窝、咽旁间隙和眼眶的各种大小的肿瘤。
