Surgical management of the infratemporal fossa ajlobby. Microanatomy and surgical approaches to the infratemporal. Despite these aids, accurate information requires a precise understanding of the different nomenclature of suprahyoid spaces used by the radiologist and clinician. It is a potential space in the side of the head, and is paired on either side. Castelnuovo european accreditation council for continuing medical education.
Infratemporal fossa, surgical anatomy, approaches, paraganglioma, mandibular nerve the infratemporal fossa itf is a continuation of the temporal fossa between the internal surface of the zygoma and the external surface of the temporal bone and greater wing of the sphenoid bone. Monitoring of the retropterygoid portion of the infratemporal fossa by this route is. The infratemporal fossa is a complex space of the face that lies posterolateral to the maxillary sinus and many important nerves and vessels traverse it gross anatomy. Infratemporal fossa an overview sciencedirect topics. Endonasal transpterygoid approach to the infratemporal. It describes in detail and in colour throughout the full range of the infratemporal fossa alongside carefully selected and appealing cadaver and surgery photos, radiographs and illustrations. Zygomatic osteotomies and middle fossa drilling are essential for the management of the infratemporal extension fig.
Dissection of the itf is essential in many of the lateral cranial base approaches and in exposure of the high cervical internal carotid artery ica. Surgical anatomy of the pterygopalatine fossa volume 89 issue 1 robert t. Endoscopic endonasal dissection of the infratemporal fossa. Microsurgical anatomy of the infratemporal fossa as viewed laterally and superiorly. It is closely associated with both the temporal and pterygopalatine fossae and acts as a conduit for neurovascular structures entering and leaving the cranial cavity. Overall, knowledge of these approaches increases the available options when neurosurgical skull base surgeons plan to resect skull base lesions with or without extensions into the infratemporal fossa. Part of the highly respected grays family, this new resource brings to life the applied anatomical knowledge that is critically important in the operating room, with a high level of detail to ensure safe and effective surgical practice. Anatomy and surgical approaches to orbit, infratemporal. Request pdf surgical anatomy of the infratemporal fossa using the transmaxillary approach in this study we evaluated the ability of the transmaxillary route to expose the elements of the. The infratemporal fossa is an irregularly shaped cavity, situated below and medial to the zygomatic arch.
It should be emphasized again that the knowledge of surgical anatomy of the middle fossa and various options of lateral skull base approaches are essential for surgery of the middle fossa meningiomas extending to the infratemporal fossa. The infratemporal fossa itf is located deep in the skull base. Correlations with traditional perspectives and surgical implications. Grays surgical anatomy pdf 1st edition download free ebooks. The infratemporal fossa is a complex area located at the base of the skull, deep to the masseter muscle it is closely associated with both the temporal and pterygopalatine fossae and acts as a conduit for neurovascular structures entering and leaving the cranial cavity this article will outline the borders and content of the fossa before examining its clinical relevance. Maxillary artery and its distribution in the deep face. Due to its difficult approach, surgical intervention at the itf has remained a heavy burden to surgeons. Surgical outcomes and postoperative complications were evaluated. The surgical approaches to the infratemporal fossa are very well explained in the chapter with the same title and create a better understanding of the complex principles and potential applications in the field. Our purpose was to design an anatomic model that illustrates the anatomy of the infratemporal fossa from the endoscopic standpoint and serves as a training model for surgeons interested in pursuing this endeavor. The present study aims to provide maxillofacial surgeons with new data concerning direct endoscopic measurement and precise.
A medial maxillectomy coupled with a transpterygoid endoscopic approach, provides adequate access to the pterygopalatine and infratemporal fossae. Endoscopic approaches are more appropriate than conventional approaches if the goal is palliation. Surgical anatomy of the infratemporal fossa john d. Our results indicate that the transmaxillary approach is a minimally invasive procedure that gives an appropriate window to the structures of the retroantral space and to the pterygomaxillary fissure and pterygopalatine fossa. The infratemporal fossa is a complex area located at the base of the skull, deep to the masseter muscle. The infratemporal fossa itf is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Surgical anatomy of the infratemporal fossa integrates the basic clinical and surgical anatomy of the regions, and it explores anatomy, local anesthesia, spread of infection, trauma, tumors, surgical access and pain. Endoscopic transnasal anatomy of the infratemporal fossa and upper parapharyngeal regions. September 21, 2012 also at 59 minute you said that maxillary artery is a branch from the internal carotid artery, i think it is from external carotid artery.
The infratemporal fossa is a space that exists below the temporal fossa when seen on the skull without the soft tissues, these two anatomical landmarks can be seen to communicate with one another the fossa is shaped irregularly and is situated below and medial to the zygomatic arch. The infratemporal fossa is the space between the skull base, lateral pharyngeal wall, and the ramus of mandible the fossa is actually open to the neck posteroinferiorly and in doing so has no true anatomical floor. It contains comprehensive clinical coverage of the infratemporal fossa with chapters relating to anatomy, local anesthesia, spread of infection, trauma, tumors, surgical access and pain. The styloid diaphragm revisited, neurosurgery, volume 43, issue 4, october 1998.
The article also demonstrates the implications of involvement of the structures of itf and ms on the t staging ajcc 7th. The aim of this study is to understand the clinical picture of gas gangrene involving the infratemporal fossa, and to be able to assess the most appropriate surgical drainage pathway indicated in each of these cases. After temporal craniotomy and epidural dissection as described previously, drilling the base of the middle. Neurovasculature of the infratemporal fossa the maxillary artery is the larger of the two terminal branches of the external carotid artery. Written and edited by expert surgeons in collaboration with a worldrenowned anatomist, this exquisitely illustrated reference consolidates surgical, anatomical and technical knowledge for the entire human body in a single volume. The second infant was operated at the age of 3 weeks using a wide. Accurate assessment of disease spread is limited by the edema of tissue, and the. An infratemporal fossa approach is a complex procedure that involves significant time, effort, and cost. Infratemporal fossa definition of infratemporal fossa by. Download grays surgical anatomy pdf book free online 1st edition from grays surgical anatomy pdf. Endoscopic anatomical study of the translateral molar. The aim of this study was to illustrate the endoscopic surgical anatomy of the infratemporal fossa itf and upper parapharyngeal space and to provide useful landmarks by comparing transnasal. Grays surgical anatomy 1st edition pdf written and edited by expert surgeons in collaboration with a worldrenowned anatomist, this exquisitely illustrated reference consolidates surgical, anatomical and technical knowledge for the entire human body in a single volume.
To explain the general concepts in clinical anatomy, especially in the field of maxillofacial surgery, in an understandable way is quite troblesome. To explain the general concepts in clinical anatomy, especially in. It is located posterior to the maxilla, between the lateral pterygoid plate of the sphenoid bone. This is a rare case report of infratemporal fossa gas gangrene or gasforming abscess. This area has complex anatomy with communications to many surrounding areas. Bhanu prakash usmle, fmge and neet pg 7,960 views 4. The third, or pterygopalatine portion, of the maxillary artery enters the pterygopalatine fossa from the infratemporal fossa via the pterygomaxillary fissure. It arises posterior to the neck of the mandible and is divided into three parts based on its relation to the lateral pterygoid muscle. Infratemporal fossa, masticator space and parapharyngeal. It is not fully enclosed by bone in all directions, and it contains superficial muscles that are visible during dissection after removing skin and fascia.
The division of the area into a prestyloid region which contains the facial nerve, parotid gland, pterygoid muscles, maxillary artery, and branches of the mandibular nerve and a retrostyloid region which contains the internal carotid artery ica, internal jugular vein, and extracranial. Available formats pdf please select a format to send. Microsurgical anatomy of the infratemporal fossa request pdf. Surgical anatomy of the infratemporal fossa using the. The infratemporal fossa itf has been a challenging area for clinicians for a long time. It contains comprehensive clinical coverage of the infratemporal fossa with chapters relating to anatomy, local anesthesia, spread of. Spetzler, surgical anatomy of the infratemporal fossa.
Videos produced in 2016 at the faculty of medicine, university of british columbia, canada. Pdf endoscopic transnasal anatomy of the infratemporal. Introduction a knowledge of the anatomy of the infratemporal and temporal fossae and their contents is. For middle fossa meningiomas extending to the infratemporal fossa, the zygomatic infratemporal approach provides the necessary exposure for total surgical resection. The infratemporal space also termed the infratemporal space or the infratemporal portion of the deep temporal space is a fascial space of the head and neck sometimes also termed fascial spaces or tissue spaces. Surgical anatomy of the infratemporal fossa integrates the basic clinical and surgical anatomy of the regions. The infratemporal fossa anatomy, from an endoscopic standpoint, is poorly understood. While clinicians are familiar with infratemporal fossa itf, radiologists are familiar with masticator space ms. The complex anatomy of the infratemporal fossa requires precise identification of surgical landmarks to assure preservation of neurovascular structures. The skull base anatomy of the infratemporal fossa is complex, requiring neurosurgeons and head and neck surgeons to have a precise knowledge of 3d details of the topography and contents of the region. Recently, the endoscopic transoral approach has enabled maxillofacial surgeons to access the itf using a less invasive approach compared to the traditional transfacial and endonasal endoscopic approaches. The infratemporal fossa borders contents teachmeanatomy. Maxillary division of trigeminal nerve v2 or vb maxillary nerve anatomy medical animations duration. Read surgical anatomy of the infratemporal fossa using the transmaxillary approach, surgical and radiologic anatomy on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.
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