Endoscopic approach to the infratemporal fossa

The infratemporal fossa is a deeply situated region that can give rise to a range of benign and malignant tumors. The endoscopic endonasal approach provides an alternative to open surgical approaches and may obviate the need for facial nerve transposition, middle ear obliteration, and brain retraction. A transmaxillary corridor with transpterygoid dissection is used to expose the pterygopalatine fossa. Further removal of the posterior wall of the maxillary sinus transgresses the pterygomaxillary fossa to provide access to the infratemporal fossa. The extradural nature of most pathology is associated with low rates of cerebrospinal fluid leakage. Understanding of the complex neurovascular anatomy of this region is essential to achieving successful resection and preventing complications.