Endoscopic anatomical study of the trans-lateral molar approach to the infratemporal fossa

  • Wei-wei Cai
  • Yan Zou
  • Zhuang Kang
  • Jian-gang Liang
  • Hai-yong HeEmail author
  • Qin-tai YangEmail author
Head & Neck



The infratemporal fossa (ITF) is located deep in the skull base. Recently, the endoscopic transoral approach has enabled maxillofacial surgeons to access the ITF using a less invasive approach compared to the traditional transfacial and endonasal endoscopic approaches.


The present study aims to provide maxillofacial surgeons with new data concerning direct endoscopic measurement and precise anatomical topography features of the endoscopic trans-lateral molar approach to ITF by comparing the endoscopic and regional anatomy of ITF. A clinical case receiving the proposed surgical approach is used to determine the feasibility of this technique.


The anatomical data were obtained by measuring the bone anatomical landmarks and analyzing the CT imaging data using GE’s Advance Windows 4.1 software on 25 subjects (50 sides). Morphological pictures of the regional anatomy and endoscopic anatomy were obtained from 6 (12 sides) adult cadaver heads, and the anatomical features were described. The present study reports the management of one case using the proposed surgical approach.


The proposed surgical approach clearly revealed neurovascular, muscular, and surgical landmarks in the ITF. The surgical case supports the minimally invasive treatment approach, which could rapidly access the ITF and completely excise benign tumors.


The anatomical studies and surgical case presentation helps us understand the spatial relationship of surgical landmarks of the surgical approach to the ITF for the treatment of benign lesions in the deep cranial base area.


Endoscope Regional anatomy Surgical approach Lateral molar Pterygopalatine fossa Infratemporal fossa 



Data collection was conducted in The Third Affiliated Hospital, Sun Yat-sen University. The dissection of cadaver heads was performed in the Anatomic Lab of The Third Affiliated Hospital, Sun Yat-sen University. Other works including CT image processing, anatomic measurement, and article writing were conducted in Panyu Central Hospital.

Compliance with ethical standards

Conflict of interest

The authors have no funding, financial relationships, or conflicts of interest to disclose.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology-Head and Neck SurgeryPanyu Central HospitalGuangzhouChina
  2. 2.Department of Radiology, The Third Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  3. 3.Department of Neurosurgery, The Third Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  4. 4.Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated HospitalSun Yat-sen UniversityGuangzhouChina

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