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Clinics (Sao Paulo) ; 72(9): 554-561, 2017 Oct.
Article de Anglais | MEDLINE | ID: mdl-29069259

RÉSUMÉ

OBJECTIVES: Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa. METHOD: We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas) and one malignant tumor. RESULTS: No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma) that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome. CONCLUSION: The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa.


Sujet(s)
Angiofibrome/chirurgie , Tumeurs du rhinopharynx/chirurgie , Neurinome/chirurgie , Fosse ptérygopalatine/chirurgie , Chirurgie endoscopique transanale/méthodes , Adolescent , Adulte , Angiofibrome/imagerie diagnostique , Angiofibrome/anatomopathologie , Carcinomes/imagerie diagnostique , Carcinomes/anatomopathologie , Carcinomes/chirurgie , Embolisation thérapeutique/méthodes , Femelle , Études de suivi , Humains , Imagerie par résonance magnétique/méthodes , Mâle , Adulte d'âge moyen , Tumeurs du rhinopharynx/imagerie diagnostique , Tumeurs du rhinopharynx/anatomopathologie , Grading des tumeurs , Neurinome/imagerie diagnostique , Neurinome/anatomopathologie , Tumeurs du nez/imagerie diagnostique , Tumeurs du nez/anatomopathologie , Tumeurs du nez/chirurgie , Fosse ptérygopalatine/imagerie diagnostique , Fosse ptérygopalatine/anatomopathologie , Reproductibilité des résultats , Études rétrospectives , Tomodensitométrie/méthodes , Résultat thérapeutique , Jeune adulte
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