Temporal Craniotomy for Surgical Access to the Infratemporal Fossa

Abstract

The infratemporal fossa is the anatomic space delineated by the pterygoid plate medially, the maxilla anteriorly, the mandible laterally, the glenoid fossa posteriorly, and the greater wing of the sphenoid superiorly. Tumors of the infratemporal fossa are uncommon and they are usually managed by otolaryngologists, occasionally in conjunction with neurosurgeons. Traditionally, the surgical access to the infratemporal fossa has involved an extensive surgical exposure with significant morbidity. We propose a surgical approach for select patients that minimizes morbidity while allowing gross total resection of lesions. The approach we describe is an extradural approach through a subtemporal craniectomy or craniotomy with the possible addition of a zygomatic osteotomy. Lesions that have a well-defined capsule and a texture that permits manipulation are ideal for this less extensive approach.