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Skull base surgery. 2000; 10(1): 1–9.
PMCID: PMC1656742

Tumors of the Infratemporal Fossa


Neoplastic processes involving the infratemporal fossa may originate from the tissues in the region, but more often are the result of extension from neighboring structures. Metastatic lesions located in the region are rarely encountered. Because of its concealed localization, tumors may remain unnoticed for some time. Clinical signs and symptoms often arise late, are insidious, and may be mistakenly attributed to other structures. The close proximity of the area to the intracranial structures, the orbit, the paranasal sinuses, the nasopharynx, and the facial area demands careful planning of surgical excision and combined procedures may be called for. Modern imaging techniques have made three-dimensional visualization of the extent of the pathology possible. Treatment depends on the histopathology and staging of the tumor. Several surgical approaches have been developed over the years. Radical tumor excision with preservation of the quality of life remain the ultimate goal for those tumors where surgery is indicated. Experience over a decade with various pathologies is presented.

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Selected References

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  • CONLEY JJ. The surgical approach to the pterygoid area. Ann Surg. 1956 Jul;144(1):39–43. [PubMed]
  • BARBOSA JF. Surgery of extensive cancer of paranasal sinuses. Presentation of a new technique. Arch Otolaryngol. 1961 Feb;73:129–138. [PubMed]
  • Tiwari R. Surgical landmarks of the infratemporal fossa. J Craniomaxillofac Surg. 1998 Apr;26(2):84–86. [PubMed]
  • Goldenberg RA. Surgeon's view of the skull base from the lateral approach. Laryngoscope. 1984 Dec;94(12 Pt 2 Suppl 36):1–21. [PubMed]
  • CONLEY JJ. TUMORS OF THE INFRATEMPORAL FOSSA. Arch Otolaryngol. 1964 May;79:498–504. [PubMed]
  • Shapshay SM, Elber E, Strong MS. Occult tumors of the infratemporal fossa: report of seven cases appearing as preauricular facial pain. Arch Otolaryngol. 1976 Sep;102(9):535–538. [PubMed]
  • Shaheen OH. Swellings of the infratemporal fossa. J Laryngol Otol. 1982 Sep;96(9):817–836. [PubMed]
  • Johnson AT, Maran AG. Extra-cranial tumours of the infratemporal fossa. J Laryngol Otol. 1982 Nov;96(11):1017–1026. [PubMed]
  • Hertzanu Y, Mendelsohn DB. Computed tomography of the infratemporal fossa in primary jaw pathology. Clin Radiol. 1984 May;35(3):203–207. [PubMed]
  • Sekhar LN, Schramm VL, Jr, Jones NF. Subtemporal-preauricular infratemporal fossa approach to large lateral and posterior cranial base neoplasms. J Neurosurg. 1987 Oct;67(4):488–499. [PubMed]
  • Lepkowski A, Dej S, Grabska M, Sośnierz M. Diagnostyka i leczenie guzów dołu podskroniowego. Otolaryngol Pol. 1991;45(6):422–425. [PubMed]
  • Vaillant JM. Chirurgie de la fosse infra-temporale. Une voie d'abord cutanée améliorée. Rev Stomatol Chir Maxillofac. 1994;95(6):446–450. [PubMed]
  • Shotton JC, Schmid S, Fisch U. The infratemporal fossa approach for adenoid cystic carcinoma of the skull base and nasopharynx. Otolaryngol Clin North Am. 1991 Dec;24(6):1445–1464. [PubMed]
  • Al-Mefty O, Smith RR. Surgery of tumors invading the cavernous sinus. Surg Neurol. 1988 Nov;30(5):370–381. [PubMed]
  • McGill T. Rhabdomyosarcoma of the head and neck: an update. Otolaryngol Clin North Am. 1989 Jun;22(3):631–636. [PubMed]
  • Schouwenburg PF, Kupperman D, Bakker FP, Blank LE, de Boer HB, Voûte TA. New combined treatment of surgery, radiotherapy, and reconstruction in head and neck rhabdomyosarcoma in children: the AMORE protocol. Head Neck. 1998 Jul;20(4):283–292. [PubMed]
  • Wijnaendts LC, van der Linden JC, van Unnik AJ, Delemarre JF, Voute PA, Meijer CJ. Histopathological classification of childhood rhabdomyosarcomas: relationship with clinical parameters and prognosis. Hum Pathol. 1994 Sep;25(9):900–907. [PubMed]
  • Favara BE. Langerhans' cell histiocytosis pathobiology and pathogenesis. Semin Oncol. 1991 Feb;18(1):3–7. [PubMed]
  • Yu RC, Chu C, Buluwela L, Chu AC. Clonal proliferation of Langerhans cells in Langerhans cell histiocytosis. Lancet. 1994 Mar 26;343(8900):767–768. [PubMed]
  • Willman CL. Detection of clonal histiocytes in Langerhans cell histiocytosis: biology and clinical significance. Br J Cancer Suppl. 1994 Sep;23:S29–S33. [PubMed]
  • Granich MS, Pilch BZ, Goodman ML. Meningiomas presenting in the paranasal sinuses and temporal bone. Head Neck Surg. 1983 Mar-Apr;5(4):319–328. [PubMed]
  • Inglis AF, Yarington CT, Jr, Bolen J. Extrameningeal meningiomas of the infratemporal fossa: diagnosis and treatment. Laryngoscope. 1987 Jun;97(6):689–692. [PubMed]
  • HOYE SJ, HOAR CS, Jr, MURRAY JE. Extracranial meningioma presenting as a tumor of the neck. Am J Surg. 1960 Sep;100:486–489. [PubMed]
  • Wolff M, Rankow RM. Meningioma of the parotid gland: an insight into the pathogenesis of extracranial meningiomas. Hum Pathol. 1971 Sep;2(3):453–459. [PubMed]
  • Farr HW, Gray GF, Jr, Vrana M, Panio M. Extracranial meningioma. J Surg Oncol. 1973 May;5(5):411–420. [PubMed]
  • Cantrell RW, Kaplan MJ, Atuk NO, Winn HR, Jahrsdoerfer RA. Catecholamine-secreting infratemporal fossa paraganglioma. Ann Otol Rhinol Laryngol. 1984 Nov-Dec;93(6 Pt 1):583–588. [PubMed]
  • Arena S, Hilal EY. Neurilemomas of the infratemporal space: report of a case and review of the literature. Arch Otolaryngol. 1976 Mar;102(3):180–184. [PubMed]
  • Beauvillain C, Calais C, Launay MC, Bordure P, Zanaret M, Legent F. Les tumeurs nerveuses de la fosse infra-temporale. Ann Otolaryngol Chir Cervicofac. 1991;108(2):107–111. [PubMed]
  • Colmenero C, Rivers T, Patron M, Sierra I, Gamallo C. Maxillofacial malignant peripheral nerve sheath tumours. J Craniomaxillofac Surg. 1991 Jan;19(1):40–46. [PubMed]
  • Chevalier D, Parent M, Lecomte-Houcke M, Piquet JJ. Liposarcome de la fosse infra-temporale. A propos d'un cas. Ann Otolaryngol Chir Cervicofac. 1991;108(4):253–255. [PubMed]
  • Enzinger FM, Smith BH. Hemangiopericytoma. An analysis of 106 cases. Hum Pathol. 1976 Jan;7(1):61–82. [PubMed]
  • Abdel-Fattah HM, Adams GL, Wick MR. Hemangiopericytoma of the maxillary sinus and skull base. Head Neck. 1990 Jan-Feb;12(1):77–83. [PubMed]
  • Mark RJ, Sercarz JA, Tran L, Selch M, Calcaterra TC. Fibrosarcoma of the head and neck. The UCLA experience. Arch Otolaryngol Head Neck Surg. 1991 Apr;117(4):396–401. [PubMed]
  • Le Vay J, O'Sullivan B, Catton C, Cummings B, Fornasier V, Gullane P, Simm J. An assessment of prognostic factors in soft-tissue sarcoma of the head and neck. Arch Otolaryngol Head Neck Surg. 1994 Sep;120(9):981–986. [PubMed]
  • Cook HF, Miller R, Yamada R. Giant cell tumor of the infratemporal fossa: report of case. J Oral Maxillofac Surg. 1986 Aug;44(8):651–656. [PubMed]
  • Toriumi DM, Shermetaro CB, Pecaro BC. Cavernous hemangioma of the infratemporal fossa. Ear Nose Throat J. 1989 Mar;68(3):252–259. [PubMed]
  • Knox RD, Pratt MF, Garen PD, Giles WC. Intramuscular hemangioma of the infratemporal fossa. Otolaryngol Head Neck Surg. 1990 Oct;103(4):637–641. [PubMed]
  • Menard M, Laccourreye O, Chabardes E, Carnot F, Brasnu D, Laccourreye H. Histiocytofibrome de la fosse infra-temporale. A propos d'un cas. Ann Otolaryngol Chir Cervicofac. 1991;108(2):103–106. [PubMed]
  • Mossböck R, Beham A, Kärcher H. Synovialom der Fossa infratemporalis: Ein Fallbericht. Dtsch Z Mund Kiefer Gesichtschir. 1988 Jul-Aug;12(4):303–306. [PubMed]
  • Rayappa CS, McArthur PD, Gangopadhyay K, Antonius JI. Solitary fibrous tumour of the infratemporal fossa. J Laryngol Otol. 1996 Jun;110(6):594–597. [PubMed]
  • Doubleday LC, Jing BS, Wallace S. Computed tomography of the infratemporal fossa. Radiology. 1981 Mar;138(3):619–624. [PubMed]
  • Chong VF, Fan YF, Khoo JB, Lim TA. Comparing computed tomographic and magnetic resonance imaging visualisation of the pterygopalatine fossa in nasopharyngeal carcinoma. Ann Acad Med Singapore. 1995 May;24(3):436–441. [PubMed]
  • Shapshay SM, McCann CF, Ucmakli A, Vaughan CW, Strong MS. Diagnosis of infratemporal fossa tumors using percutaneous core needle biopsy. Head Neck Surg. 1979 Sep-Oct;2(1):35–41. [PubMed]
  • Spearman M, Curtin H, Dusenbery D, Janecka IP, Reyna EL. Computed tomography-directed fine needle aspiration of skull base parapharyngeal and infratemporal fossa masses. Skull Base Surg. 1995;5(4):199–205. [PMC free article] [PubMed]
  • Fisch U. Infratemporal fossa approach to tumours of the temporal bone and base of the skull. J Laryngol Otol. 1978 Nov;92(11):949–967. [PubMed]
  • Fisch U, Fagan P, Valavanis A. The infratemporal fossa approach for the lateral skull base. Otolaryngol Clin North Am. 1984 Aug;17(3):513–552. [PubMed]
  • Holliday MJ, Nachlas N, Kennedy DW. Uses and modifications of the infratemporal fossa approach to skull-base tumors. Ear Nose Throat J. 1986 Mar;65(3):101–106. [PubMed]
  • Attia EL, Bentley KC, Head T, Mulder D. A new external approach to the pterygomaxillary fossa and parapharyngeal space. Head Neck Surg. 1984 Mar-Apr;6(4):884–891. [PubMed]
  • Kornfehl J, Gstöttner W, Kontrus M, Sedivy R. Transpalatine excision of a cavernous hemangioma of the infratemporal fossa. Eur Arch Otorhinolaryngol. 1996;253(3):172–175. [PubMed]
  • Krause CJ, Baker SR. Extended transantral approach to pterygomaxillary tumors. Ann Otol Rhinol Laryngol. 1982 Jul-Aug;91(4 Pt 1):395–398. [PubMed]
  • Catalano PJ, Biller HF. Extended osteoplastic maxillotomy. A versatile new procedure for wide access to the central skull base and infratemporal fossa. Arch Otolaryngol Head Neck Surg. 1993 Apr;119(4):394–400. [PubMed]
  • Hernández Altemir F. Transfacial access to the retromaxillary area. J Maxillofac Surg. 1986 Jun;14(3):165–170. [PubMed]
  • Wei WI, Lam KH, Sham JS. New approach to the nasopharynx: the maxillary swing approach. Head Neck. 1991 May-Jun;13(3):200–207. [PubMed]
  • Janecka IP, Sen CN, Sekhar LN, Arriaga M. Facial translocation: a new approach to the cranial base. Otolaryngol Head Neck Surg. 1990 Sep;103(3):413–419. [PubMed]

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