Endoscopy ; Humans ; Pterygopalatine Fossa ; surgery

Chronic invasive fungal sinusitis is a slowly destructive process that most commonly affects the ethmoid and sphenoid sinus, but may involve any paranasal sinus. The disease typically has a time course over 12 weeks. Pathologically, it is characterized as a dense accumulation of hyphae, occasional vascular invasion and sparse inflammatory reaction with involvement of local structures. Aspergillus fumigates is the most common pathogen. In this report, we present a patient with chronic invasive fungal sinusitis invading pterygopalatine fossa, which was presented as only mild thickening of posterior wall of maxillary sinus at initial CT scan.
Aspergillus ; Humans ; Hyphae ; Maxillary Sinus ; Pterygopalatine Fossa ; Sinusitis ; Sphenoid Sinus

Brain Neoplasms ; diagnosis ; surgery ; Child ; Female ; Humans ; Pterygopalatine Fossa

There are several options for the management of patients with locally recurred nasopharyngeal carcinoma after irradiation. Many patients can benefit from reirradiation but the complications of high dose irradiation for the second time are often severe and unbearable. In some patients, the recurred lesion may persist even after the reirradiation. Obtaining an adequate exposure of the nasopharynx for an oncologic surgical procedure has been challenging because of its surgical inaccessibility. However, improvements in the surgical approaches to the nasopharynx and paranasopharynx have been made in recent years. Two illustrative cases, in which we performed salvage surgery, are presented in this article. Using the maxillary swing approach, we removed the recurrent nasopharyngeal tumor in a 43 year old female patient. The reassembly of the osseous and soft tissues was not difficult and the associated morbidity was acceptable. In a 19 year old male patient, subtemporal-preauricular infratemporal fossa approach was performed with low morbidity for the removal of tumor recurred at the pterygopalatine fossa.
Adult ; Female ; Humans ; Male ; Nasopharynx ; Pterygopalatine Fossa ; Young Adult

The surgical approach to juvenile nasopharyngeal angiofibroma (JNA) is determined by the topographic localization, the extent of the tumor, and the experience of the surgical team.1)2) Current surgical options include lateral rhinotomy, midfacial degloving, transpalatal, infratemporal fossa, and transnasal approaches.2)3) Recently, the transnasal endoscopic surgical approach has sometimes been applied to treat benign tumors such as JNA.1)3)4) Transnasal endoscopic excision of a case of JNA limited to the left posterior nasal cavity, nasopharynx, and anterior pterygopalatine fossa was performed successfully on a 17-year old male patient. An endoscopic follow-up at postoperative two years did not indicate residual tumor or recurrence.
Adolescent ; Angiofibroma* ; Follow-Up Studies ; Humans ; Male ; Nasal Cavity ; Nasopharynx ; Neoplasm, Residual ; Pterygopalatine Fossa ; Recurrence

Endoscopy ; methods ; Female ; Humans ; Meningocele ; surgery ; Middle Aged ; Pterygopalatine Fossa ; surgery

OBJECTIVETo investigate the feasibility of image navigation technology in endoscopic skull base surgery.

METHODSThis study consisted of 75 patients who underwent the endoscopic operations with the help of the image navigation system by the same surgeon between March 2010 and March 2013. The time to prepair image navigation system, identifying anatomical structure, complications, tumor resection, and follow-up results were analysed.

RESULTSThe application of image navigation technology in the endoscopic skull base operations was both safe and reliable for delineation of tumors and identification of vital structures hidden or encased by the tumors, such as internal carotid artery, optic canal, comb, saddle bottom, foramen rotundum, foramen ovale, foramen lacerum, jugular foramen, cerebral dura mater. The tumor was removed completely, subtotally, or partially. All patients were successfully registered with accuracy, and the preoperative time was 8-15 minutes for preparation, 11 minutes in average. The target error was less than or equal to 1.5 mm. With guidance of the image navigation system, all patients were successfully operated on without serious complication. There were 13 cases with anterior skull base tumor, all were removed completely. There were 28 cases with sella region tumor, 21 totally resected, 7 subtotally resected. There were 20 cases with petroclival region tumor, 12 totally resected, 5 subtotally resected, 3 partially resected. There were 14 cases with pterygopalatine fossa and/or infratemporal fossa region tumor, 11 totally resected, 3 subtotally resected. All patients were available for follow-up (mean = 26 months) except 6 cases.

CONCLUSIONImage navigation technology can be applied in endoscopic skull base operations with advantages of accurately locating, clearly marking, significantly decreasing incidence of complications, and maximally removing the lesions.

In neurofibroma, not only schwann cells but also perineural cell, endoneural cells, and fibroblastoid cells create the tumor mass. Simple, isolated neurofibroma are common in the skin but rare in the eye. Simple isolated neurofibroma of the eye are common in the superior orbit, and a case with an isolated neurofibroma of the orbit and maxillary antrum has been reported. The authors have experienced a 57-year-old male patient who complained exophthalmos on his left eye for 2 years. The neurofibroma of the orbit and pterygopalatine fossa was confirmed and reported with a review of literature.
Exophthalmos ; Humans ; Male ; Maxillary Sinus ; Middle Aged ; Neurofibroma* ; Orbit* ; Pterygopalatine Fossa* ; Schwann Cells ; Skin

With the increasing use of stereotactic radiosurgery, recent reports have suggested that stereotactic radiosurgery may induce secondary malignancies. While the risk of secondary malignancy after conventional radiotherapy is well known, its development after stereotactic radiosurgery has been reported in only a few cases. Here we present the case of a 56-year-old female with visual disturbance of sudden onset. She underwent trans-sphenoidal surgery for a pituitary adenoma 13 years earlier. Imaging studies revealed a newly developed pituitary mass invading the right carvenous sinus. Gross total resection of the tumor was performed using a trans-sphenoidal and pterygopalatine fossa approach. The histological diagnosis was pituitary epithelioid osteosarcoma. Clinicians should be aware of the rare occurrence of radiation-induced pituitary sarcoma as a potentially fatal late complication of stereotactic radiosurgery.
Diagnosis ; Female ; Humans ; Middle Aged ; Osteosarcoma* ; Pituitary Neoplasms* ; Pterygopalatine Fossa ; Radiosurgery ; Radiotherapy ; Sarcoma

Angiofibromas are rare histologically benign tumors that predominantly affect adolescent males and account for approximately 0.5% of all neoplasms of the head and neck. Although angiofibromas are histologically benign, but locally invasive. These tumors are highly vascular and associated with extension to the nose, paranasal sinus, pterygomaxillary fossa, infratemporal fossa, intracranium, and neck. The morbidity and mortality associated with these tumors are related to its prominent vascularity and its propensity for aggressive local growth. Pre-operative embolization is useful for reducing intraoperative blood loss and the risk of incomplete excision of the tumor. These tumors virtually arise from the nasopharynx in the region of the sphenopalatine foramen and pterygopalatine fossa. We present a unique case of an angiofibroma limited to the left parapharyngeal space, without involvement of the sphenopalatine foramen or nasopharynx. We treated this case with transparotid-cervical approach after pre-operative embolization.
Adolescent ; Angiofibroma* ; Head ; Head and Neck Neoplasms ; Humans ; Male ; Mortality ; Nasopharynx ; Neck ; Nose ; Pterygopalatine Fossa