Search tips
Search criteria 


Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
Skull base surgery. 2000; 10(3): 109–117.
PMCID: PMC1656823

Functional Outcomes of the Retromaxillary-Infratemporal Fossa Dissection for Advanced Head and Neck/Skull Base Lesions


The retromaxillary-infratemporal fossa (RM-ITF) dissection, using a preauricular incision, was initially popularized for the treatment of temporomandibular joint disorders, facial fractures, and orbital tumors. This approach has been expanded for the treatment of advanced head and neck and skull base tumors extending into the infratemporal fossa. We studied prospectively eight consecutive patients requiring a RM-ITF dissection. Pre- and postoperative functional outcomes measured were mastication, speech, swallowing, cranial nerve function, pain, and cosmesis. A significant reduction in pain was noted postoperatively in all patients studied. Limited changes were identified in mastication, speech, swallowing, vision, hearing, or cosmesis postoperatively. The RM-ITF dissection should be considered when resecting advanced head and neck/skull base lesions that extend into this region. We have found minimal morbidity associated with this dissection. This procedure may have a useful place in palliation of patients with incurable pain caused by tumor invasion into the infratemporal fossa.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Irish JC, Gullane PJ, Gentili F, Freeman J, Boyd JB, Brown D, Rutka J. Tumors of the skull base: outcome and survival analysis of 77 cases. Head Neck. 1994 Jan-Feb;16(1):3–10. [PubMed]
  • Osguthorpe JD. Sinus neoplasia. Arch Otolaryngol Head Neck Surg. 1994 Jan;120(1):19–25. [PubMed]
  • McCaffrey TV, Olsen KD, Yohanan JM, Lewis JE, Ebersold MJ, Piepgras DG. Factors affecting survival of patients with tumors of the anterior skull base. Laryngoscope. 1994 Aug;104(8 Pt 1):940–945. [PubMed]
  • Leonetti JP, al-Mefty O, Eisenbeis JF, Carr WC., Jr Orbitocranial exposure in the management of infratemporal fossa tumors. Otolaryngol Head Neck Surg. 1993 Oct;109(4):769–772. [PubMed]
  • Zhang M, Garvis W, Linder T, Fisch U. Update on the infratemporal fossa approaches to nasopharyngeal angiofibroma. Laryngoscope. 1998 Nov;108(11 Pt 1):1717–1723. [PubMed]
  • Fagan JJ, Snyderman CH, Carrau RL, Janecka IP. Nasopharyngeal angiofibromas: selecting a surgical approach. Head Neck. 1997 Aug;19(5):391–399. [PubMed]
  • CONLEY JJ. The surgical approach to the pterygoid area. Ann Surg. 1956 Jul;144(1):39–43. [PubMed]
  • Fisch U. The infratemporal fossa approach for nasopharyngeal tumors. Laryngoscope. 1983 Jan;93(1):36–44. [PubMed]
  • Samy LL, Girgis IH. Transzygomatic approach for nasopharyngeal fibromata with extrapharyngeal extension. J Laryngol Otol. 1965 Sep;79(9):782–795. [PubMed]
  • Obwegeser HL. Temporal approach to the TMJ, the orbit, and the retromaxillary-infracranial region. Head Neck Surg. 1985 Jan-Feb;7(3):185–199. [PubMed]
  • Wetmore SJ, Suen JY, Snyderman NL. Preauricular approach to infratemporal fossa. Head Neck Surg. 1986 Nov-Dec;9(2):93–103. [PubMed]
  • House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985 Apr;93(2):146–147. [PubMed]
  • Mann WJ, Gilsbach J, Seeger W, Flöel H. Use of a malar bone graft to augment skull-base access. Arch Otolaryngol. 1985 Jan;111(1):30–33. [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]
  • Throckmorton GS, Talwar RM, Ellis E., 3rd Changes in masticatory patterns after bilateral fracture of the mandibular condylar process. J Oral Maxillofac Surg. 1999 May;57(5):500–509. [PubMed]
  • Palmieri C, Ellis E, 3rd, Throckmorton G. Mandibular motion after closed and open treatment of unilateral mandibular condylar process fractures. J Oral Maxillofac Surg. 1999 Jul;57(7):764–776. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers