Analysis of the Expanded Endonasal and Far Medial Transoral Endoscopic Approaches to the Infratemporal Fossa: Feasibility Study for a Multi-Portal Minimally Invasive Approach

Abstract

Background: Recent advances in endoscopic technology have led to minimally invasive approaches to the infratemporal fossa (ITF), such as endonasal approaches. These obviate some of the morbidity associated with traditional open approaches; however, access to the most lateral regions of the ITF are still limited and often require expanded endonasal or transoral approaches. The expanded endonasal approaches may include contralateral transeptal approach, extended medial maxillectomy, endoscopic Denker approach, or Caldwell-Luc approach, which are associated with their own unique complications. To obviate these associated morbidities, we are proposing a multiportal minimally invasive approach to the ITF which would involve combination of transnasal, transoral, and possibly transfacial approaches. Anatomic perspective is key in successful endoscopic surgery. In this study, we show comparative surgical anatomy between the transnasal and transoral approaches.