Joo Hye Ah, Park Na-Kyum, Chung Jong Woo
Department of Otorhinolaryngology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong 18450, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
J Clin Med. 2025 Jul 26;14(15):5294. doi: 10.3390/jcm14155294.
To evaluate the outcomes of a modified infratemporal fossa approach (ITFA) that preserves the posterior external auditory canal (EAC) in patients with tumors in the infratemporal fossa and skull base, focusing on postoperative hearing and facial nerve function. This retrospective study included nine patients who underwent ITFA with posterior EAC preservation for tumor removal while minimizing facial nerve rerouting. All surgeries were performed by a single surgeon. Preoperative and postoperative hearing levels, facial nerve function, tumor characteristics, and surgical outcomes were analyzed. Air-bone gaps (ABG) were assessed using pure tone audiometry, and facial nerve function was assessed using the House-Brackmann grading system. The cohort consisted of eight female patients and one male patient, with a mean tumor size of 3.0 cm. Surgical outcomes were promising, with no statistically significant increase in postoperative ABG and well-preserved facial nerve function. Only one patient developed postoperative grade II facial palsy. A residual tumor was identified in one case with extensive meningioma, which has remained stable, and no recurrence or regrowth was noted during the follow-up period (mean: 3.7 years). The modified approach minimized complications related to conductive hearing loss and facial nerve dysfunction. The modified ITFA with posterior EAC preservation provides a promising alternative to conventional ITFA for managing deep-seated tumors. It preserves both hearing and facial nerve function while ensuring adequate tumor resection.
为评估一种改良颞下窝入路（ITFA）在治疗颞下窝和颅底肿瘤患者时保留外耳道后壁（EAC）的效果，重点关注术后听力和面神经功能。这项回顾性研究纳入了9例接受保留外耳道后壁的ITFA手术以切除肿瘤并尽量减少面神经改道的患者。所有手术均由同一外科医生进行。分析了术前和术后的听力水平、面神经功能、肿瘤特征及手术结果。采用纯音听力测定法评估气骨导差（ABG），并使用House-Brackmann分级系统评估面神经功能。该队列包括8例女性患者和1例男性患者，肿瘤平均大小为3.0 cm。手术结果令人满意，术后ABG无统计学意义的显著增加，面神经功能得以良好保留。仅1例患者术后出现Ⅱ级面瘫。1例广泛脑膜瘤患者术后发现有残留肿瘤，该残留肿瘤一直稳定，随访期间（平均3.7年）未发现复发或再生长。改良入路将与传导性听力损失和面神经功能障碍相关的并发症降至最低。保留外耳道后壁的改良ITFA为处理深部肿瘤提供了一种有前景的替代传统ITFA的方法。它在确保充分切除肿瘤的同时保留了听力和面神经功能。
