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Infratemporal fossa approach: the modified zygomatico-transmandibular approach

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Issue Date
2019-01-11
Publisher
Springer Open
Citation
Maxillofacial Plastic and Reconstructive Surgery. 2019 Jan 11;41(1):3
Keywords
Infratemporal fossaInfratemporal fossa approachZygomatico-transmandibular approachLateral skull base dissectionPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA
Abstract
Background
The infratemporal fossa (ITF) is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Due to its difficult approach, surgical intervention at the ITF has remained a heavy burden to surgeons. The aim of this article is to review basic skull base approaches and ITF structures and to avoid severe complications based on the accurate surgical knowledge.

Methods
A search of the recent literature using MEDLINE (PubMed), Embase, Cochrane Library, and other online tools was executed using the following keyword combinations: infratemporal fossa, subtemporal fossa, transzygomatic approach, orbitozygomatic approach, transmaxillary approach, facial translocation approach, midface degloving, zygomatico-transmandibular approach, and lateral skull base. Aside from our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) trial, there have been very few randomized controlled trials. The search data for this review are summarized based on the authors diverse clinical experiences.

Results
We divided our results based on representative skull base approaches and the anatomy of the ITF. Basic approaches to the ITF include endoscopic endonasal, transzygomatic, orbitozygomatic, zygomatico-transmandibular, transmaxillary, facial translocation, and the midfacial degloving approach. The borders and inner structures of the ITF (with basic lateral skull base dissection schemes) are summarized, and the modified zygomatico-transmandibular approach (ZTMA) is described in detail.

Conclusions
An anatomical basic knowledge would be required for the appropriate management of the ITF pathology for diverse specialized doctors, including maxillofacial, plastic, and vascular surgeons. The ITF approach, in conjunction with the application of microsurgical techniques and improved perioperative care, has permitted significant advances and successful curative outcomes for patients having malignancy in ITF.
ISSN
2288-8586
Language
English
URI
https://doi.org/10.1186/s40902-018-0185-x

https://hdl.handle.net/10371/147136
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College of Dentistry/School of Dentistry (치과대학/치의학대학원)Dental Research Institute (치학연구소)Journal Papers (저널논문_치학연구소)
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