Wang Jian, DU Weijia, Zhu Zhengru, Lai Yubin, Chen Xiaodong, Xue Tao, Chen Fuquan
Department of Otolaryngology Head and Neck Surgery,Xijing Hospital,Air Force Medical University,Xi'an,710032,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Aug;36(8):597-603. doi: 10.13201/j.issn.2096-7993.2022.08.006.
According to the characteristics of endoscopic transnasal and transoral surgery for infratemporal fossa tumors, we divided and named subzones of the infratemporal fossa, to explore the approaches of endoscopic transnasal and transoral surgery for infratemporal fossa tumors, and to analyze their advantages and disadvantages. We retrospectively analyzed the clinical data of 36 patients with benign tumors of infratemporal fossa successfully resected through nose or mouth under endoscope, summarized and analyzed the localization characteristics of these tumors in infratemporal fossa, and made a subzone naming rule of infratemporal fossa. We also summarized the selection principles, advantages and disadvantages of endoscopic transnasal and transoral surgical approaches. The infratemporal fossa area is divided into ABC area. Area A is the fat pad area posterolateral of maxillary sinus. Area B is further divided into B1 (above the plane of maxillary sinus floor, anterior styloid process), B2 (below the plane of maxillary sinus floor, anterior styloid process), and B3 (posterior styloid process to anterior vertebra); Area C is retropharyngeal and eustachian tube area. The location of the tumor in the infratemporal fossa determines the choice of transnasal and transoral approaches. All tumors were completely removed, and no tumor recurred during the follow-up. A few patients had temporary local sensory function decline, and recovered during the follow-up. The infratemporal fossa region naming rule according to the characteristics of endoscopic transoral and transnasal surgery approach is simple and practical, which can effectively guide the operation of the infratemporal fossa region and has clinical application value.
根据颞下窝肿瘤鼻内镜经鼻和经口手术的特点,我们对颞下窝进行分区并命名,以探索鼻内镜经鼻和经口手术治疗颞下窝肿瘤的入路,并分析其优缺点。我们回顾性分析了36例经鼻内镜或口内镜成功切除的颞下窝良性肿瘤患者的临床资料,总结分析这些肿瘤在颞下窝的定位特点,并制定了颞下窝分区命名规则。我们还总结了鼻内镜经鼻和经口手术入路的选择原则、优缺点。将颞下窝区域分为ABC区。A区为上颌窦后外侧脂肪垫区。B区进一步分为B1(上颌窦底平面以上、茎突前方)、B2(上颌窦底平面以下、茎突前方)和B3(茎突后方至椎体前方);C区为咽后和咽鼓管区。肿瘤在颞下窝的位置决定了经鼻和经口入路的选择。所有肿瘤均完全切除,随访期间无肿瘤复发。少数患者出现局部感觉功能暂时下降,随访期间恢复。根据鼻内镜经口和经鼻手术入路特点制定的颞下窝区域命名规则简单实用,能有效指导颞下窝区域手术,具有临床应用价值。