Recurrent Ameloblastoma Involving Infratemporal Fossa
Recurrent Ameloblastoma Involving Infratemporal Fossa
The subtemporal preauricular approach to the infratemporal fossa (ITF) is ideal in the surgical exposure and resection of any lesion, benign or malignant, which involves the ITF and adjacent regions. In contrast to Fisch’s infratemporal fossa approaches, this approach to the ITF affords access to this area without loss of hearing.
It is an approach to the skull base through the anterior portion of the petrous temporal bone and is used for the removal of predominantly extradural tumors in this region. This approach can be used for the management of intradural lesions in the region of the clivus. Its main advantages include avoidance of brain retraction, the use of an extrapharyngeal route, and exposure of the ventral aspect of the pons and medulla and related structures caudal to the trigeminal root.
Fig.1 Recurrent ameloblastoma of mandible s/p mandibulectomy. Coronal CT shows tumour in temporal and infratemporal fossa displacing zygoma (yellow arrow) and zygomatic arch.
Fig.2 Coronal CT shows tumour in temporal and infratemporal fossa displacing zygoma and zygomatic arch (yellow arrow).
Fig.3 Incision-is-marked
Fig.4 Skin flap is raised.Green arrow points at the parotid gland. Yellow arrow points at the tumour.
Fig.5 Superficial lobe og the parotid is dissected after identifying and preserving the facial nerve and its branches (green arrows), Facial nerve branches were freed from deep lobe.
Fig.6 The tumour, deep lobe of parotid and the zygomatic arch were removed. Yellow arrow – facial nerve trunk. Green arrows – facial nerve branches.
Fig.7 The defect was reconstructed using anterolateral thigh microvascular flap (yellow arrow). Green arrows – facial nerve branches.
Fig.8 6 months post-op. Good facial nerve function with mild paresis at the angle of mouth.
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)