Transtemporal Approach
Transtemporal Approach
Fig.1 37 yrs old male with recurrent Ca nasopharynx sp chemoradiation. Tumour involves nasopharynx, ITF, carotid sheath & vertical petrous ICA.
Fig.2 CT shows tumour involving parapharyngeal ICA (red arrow).
Fig.3 Balloon test occlusion done showed good cross circulation Through circle of willis. Permanent balloon occlusion of ICA was done dital to the area of tumour.
Fig.4 Plan to do subtotal petrosectomy + en-bloc resection of ramus, content of ITF, lateral wall of nasopharynx & oropharynx and ICA.
Fig.5 Postaural incision. Subtotal petrosectomy, ITF clearance, excision of lateral wall of nasopharynx and oropharynx. ICA was excised. After resection, posterior end of nasal septum, contralateral eustachian tube & resected end of ICA are seen.
Fig.6 Facial nerve was grafted. Reconstruction was done using rectus abdominis microvascular flap (yellow arrows). Post-op scan.
Fig.7 Post-op axial scan. Flap is filling one half of nasopharynx and ITF (yellow arrows).
Fig.8 Two years post-op. Good facial symmetry.
The Heart Of Clinic
Dr. C. Rayappa MBBS, DLO, FRCS(Edin)
SENIOR CONSULTANT
+91 44 3315 1105
Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)
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The Heart Of Clinic
Dr. C. Rayappa MBBS, DLO, FRCS(Edin)
SENIOR CONSULTANT
+91 44 3315 1105
Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)