Soo Kyung, Min Hyun Jin
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, Seoul, Korea.
J Craniofac Surg. 2024 Jan 29. doi: 10.1097/SCS.0000000000009987.
The infratemporal fossa (ITF) is an area surrounded by bony structures and contains vital organs. Although a large abscess in the ITF is not common, it requires prompt surgical management. Recently, the authors had a patient who presented with fever, pain, and trismus. The patient was diagnosed with an abscess in the ITF, although the authors were not able to determine the exact cause of the infection. The lesion was accessed through the posterolateral maxillary wall using nasal endoscopy with a navigation system. The abscess was safely drained through a small bony window. This case suggests that the nasal endoscopic approach, combined with the use of a navigation system, allows for an easy and safe surgical approach to the ITF. In addition, the authors' observations indicate that minimal mucosal thickening without definite evidence of sinusitis could result in an abscess in the ITF in immune-compromised patients, as was the case with the authors' patients.
颞下窝(ITF)是一个被骨性结构包围的区域,包含重要器官。虽然ITF内出现大脓肿并不常见,但需要及时进行手术处理。最近,作者遇到一位出现发热、疼痛和牙关紧闭症状的患者。该患者被诊断为ITF脓肿,尽管作者未能确定感染的确切原因。通过使用带有导航系统的鼻内镜经上颌骨后外侧壁进入病变部位。脓肿通过一个小骨窗被安全引流。该病例表明,鼻内镜方法结合导航系统的使用,可为ITF提供一种简便且安全的手术入路。此外,作者的观察结果表明,在免疫功能低下的患者中,如作者的患者那样,即使没有明确鼻窦炎证据的轻微黏膜增厚也可能导致ITF脓肿。