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      Combined endoscopic and open approach for a salivary gland carcinoma at the pterygoid region Translated title: Abordaje combinado en un carcinoma de pterigoides derecha: nota técnica

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          Abstract

          ABSTRACT Tumours located in the pterygopalatine and infratemporal fossae are challenging to access, which may comprise oncological results. Both open and endoscopic approaches have been used in the literature, each showing advantages and disadvantages over the other. We report a technical note in a case of a malignant tumor in the pterygopalatine fossae which was excised combining an open transmaxillary approach and an endoscopic transnasal approach. We believe that a combined approach offers more security in the oncological resection, minimizing the aggressivity of the open approach through the endoscopic assistance.

          Translated abstract

          RESUMEN Las tumoraciones localizadas en la región pterigopalatina y en la fosa infratemporal son difíciles de acceder, lo que puede comprometer los resultados oncológicos. Existen abordajes abiertos y endoscópicos, cada uno con ventajas e inconvenientes. Presentamos un caso de una tumoración en fosa pterigopalatina que fue extirpada mediante un abordaje combinado endoscópico nasal y abierto transmaxilar. Creemos que ofrecer un abordaje combinado establece la posibilidad de ofrecer mayor seguridad en cuanto a la resección, minimizando la agresividad del abordaje abierto con la asistencia endoscópica.

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          Most cited references10

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          Endoscopic approach to the infratemporal fossa: anatomic study.

          Classic surgical exposures of the infratemporal fossa region, including the adjacent intracranial space, temporal bone, and sinonasal region, require the extensive exposure associated with the transcranial, transfacial, and transmandibular approaches with their inherent neurological and cosmetic morbidities. In this study, we evaluated the feasibility and exposure afforded by combining 2 endoscopic transmaxillary approaches, endonasal and Caldwell-Luc supplement, to the infratemporal fossa.
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            Anterior clivectomy: surgical technique and clinical applications.

            Midline clival lesions, whether involving the clivus or simply situated anterior to the brainstem, present a technical challenge for adequate exposure and safe resection. The authors describe, as a minimally invasive technique, an anterior clivectomy performed via an expanded transsphenoidal approach coupled with the use of a neuronavigation on mobile head and endoscopic-assisted technique. Wide and direct exposure, with the ability to resect extra- and intradural tumors, was achieved without mortality and with a low rate of complications.
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              Endoscopic transnasal transpterygopalatine fossa approach to the lateral recess of the sphenoid sinus.

              Lesions affecting the lateral recess of the sphenoid sinus are rarely discussed in the literature as a separate entity. This region is difficult to visualize and manipulate through the transnasal routes, especially when extensive pneumatization is present. External approaches to this area involve extensive surgery and are associated with significant morbidity. The objectives of this study are to present our experience with the endoscopic transpterygopalatine fossa approach as a method for exposing and manipulating lesions of the lateral recess of the sphenoid and to illustrate the detailed surgical steps of the procedure.
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                Author and article information

                Journal
                maxi
                Revista Española de Cirugía Oral y Maxilofacial
                Rev Esp Cirug Oral y Maxilofac
                Sociedad Española de Cirugía Oral y Maxilofacial y de Cabeza y Cuello (Madrid, Madrid, Spain )
                1130-0558
                2173-9161
                March 2021
                : 43
                : 1
                : 40-43
                Affiliations
                [2] Madrid orgnameLa Paz Hospital orgdiv1Otorrinolaringology department Spain
                [1] Madrid orgnameLa Paz University Hospital orgdiv1Oral and Maxillofacial Surgery Department Spain
                Article
                S1130-05582021000100040 S1130-0558(21)04300100040
                10.20986/recom.2020.1123/2020
                c5036952-4e72-47d1-8c48-791e7f40e327

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 15 April 2020
                : 18 February 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 4
                Product

                SciELO Spain

                Categories
                Case Reports

                intraoperative navigation,endoscopic approach,Abordaje combinado,fosa pterigopalatina,Combined approach,abordaje endoscópico,navegación intraoperatoria,pterygopalatine fossa

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