Aim of the study: Tumours of the infratemporal fossa (ITF) are rare and include primary tumours, contiguity lesions and metastases. Surgical resection is the gold standard. The fronto-orbito-zygomatic (FOZ) approach is commonly used in order to obtain safe access to the lateral skull base and ITF to resect intra- and extra-cranial tumours. We here describe our series of ITF lesions extending to the middle cranial fossa and/or orbit, treated by single- or two piece FOZ. Material and methods: All cases of single- or two-piece FOZ approach for an infratemporal fossa lesion extending to the middle cranial fossa operated at our Institution from January 2014 to January 2018 were retrospectively reviewed. The follow-up was for a minimum of four months and a maximum of 60 months. The inclusion criteria were lesions involving the ITF with an extension to the middle cranial fossa and/or orbit. Baseline characteristics of patients, tumour localisation, tumour extension, diffusion route, histology, extent of tumour resection, postoperative treatment, and post-operative complications were evaluated. Results: Nine patients underwent a surgical procedure with a FOZ approach, two of them with a single-piece approach and the remainder with a two-piece one. All patients had an ITF localisation. Gross total removal (GTR) was achieved in 7/9 patients. Only one patient, with non-total removal (NTR), underwent radiotherapy. Conclusions: For the treatment of ITF fossa tumours extending to the orbit and or middle cranial fossa, we believe that both FOZ techniques are effective and allow a good medial extension toward the cavernous sinus and parasellar region. But a two-piece craniotomy may ensure a more medial extension and a wider angle of work compared to a one-piece craniotomy.

Fronto-orbito-zygomatic (FOZ) approach for infratemporal fossa lesions extending to middle cranial fossa: our experience and review of literature / Mancini, Fabrizio; Marini, Alessandra; Paracino, Riccardo; Consorti, Giuseppe; Iacoangeli, Maurizio; Dobran, Mauro. - In: NEUROLOGIA I NEUROCHIRURGIA POLSKA. - ISSN 0028-3843. - ELETTRONICO. - (2022). [10.5603/PJNNS.a2022.0023]

Fronto-orbito-zygomatic (FOZ) approach for infratemporal fossa lesions extending to middle cranial fossa: our experience and review of literature

Mancini, Fabrizio
;
Paracino, Riccardo
Membro del Collaboration Group
;
Iacoangeli, Maurizio
Writing – Review & Editing
;
Dobran, Mauro
Writing – Original Draft Preparation
2022-01-01

Abstract

Aim of the study: Tumours of the infratemporal fossa (ITF) are rare and include primary tumours, contiguity lesions and metastases. Surgical resection is the gold standard. The fronto-orbito-zygomatic (FOZ) approach is commonly used in order to obtain safe access to the lateral skull base and ITF to resect intra- and extra-cranial tumours. We here describe our series of ITF lesions extending to the middle cranial fossa and/or orbit, treated by single- or two piece FOZ. Material and methods: All cases of single- or two-piece FOZ approach for an infratemporal fossa lesion extending to the middle cranial fossa operated at our Institution from January 2014 to January 2018 were retrospectively reviewed. The follow-up was for a minimum of four months and a maximum of 60 months. The inclusion criteria were lesions involving the ITF with an extension to the middle cranial fossa and/or orbit. Baseline characteristics of patients, tumour localisation, tumour extension, diffusion route, histology, extent of tumour resection, postoperative treatment, and post-operative complications were evaluated. Results: Nine patients underwent a surgical procedure with a FOZ approach, two of them with a single-piece approach and the remainder with a two-piece one. All patients had an ITF localisation. Gross total removal (GTR) was achieved in 7/9 patients. Only one patient, with non-total removal (NTR), underwent radiotherapy. Conclusions: For the treatment of ITF fossa tumours extending to the orbit and or middle cranial fossa, we believe that both FOZ techniques are effective and allow a good medial extension toward the cavernous sinus and parasellar region. But a two-piece craniotomy may ensure a more medial extension and a wider angle of work compared to a one-piece craniotomy.
2022
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11566/298928
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