측두하와로 전이된 상악 제3대구치: 증례보고

김희열 대한통합치과학회 2021 대한통합치과학회지 Vol.10 No.2

Although it is not common for a maxillary third molar to be displaced into the infratemporal fossa during the extraction, it could happen by an inappropriate direction of action. The infratemporal fossa consists of important structures such as the internal maxillary artery, the venous pterygoid plexus, the sphenopalatine nerve, the coronoid process of the mandible, and the pterygoid muscles. Therefore, there is a risk of nerve damage and bleeding in the process of removing the displaced tooth. However, it is recommended to extract the displaced tooth from the infratemporal fossa to prevent infection and restriction of mandibular movement, and relieve psychological anxiety of the patient. There is debate about the timing of its removal. The tooth can be removed intraorally or extra orally using equipment such as an endoscope. This report introduces an immediate intraoral extraction method in which the maxillary third molar was displaced to the infratemporal fossa during the extraction under the local anesthesia.

측두하와에 발생한 악성 섬유성 조직구성

이경희,허민석,이삼선,최순철,Lee Kyung-Hee,Heo Min-Suk,Lee Sam-Sun,Choi Soon-Chul 대한영상치의학회 1999 Imaging Science in Dentistry Vol.29 No.2

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life. but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area. the lateral wall of the maxillary sinus. and the ascending ramus of mandible. MRI demonstrated a well defined mass of intermediate signal intensitiy in Tl weighted images but T2 weighted images showed two distinctive regions of different characteristics. Upper portion of the lesion was of hyperintense signal but (at) lower portion, the signal intensity decreased clearly, which might mean that this lesion(mass) is composed of two different subtypes though it couldn't be confirmed by histopathological examination. Biopsy was taken the lesion as only in the soft tissue of the maxillary posterior alveolar region and confirmed the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.

측두하와에 발생한 악성 섬유성 조직구종

허민석,이삼선,최순철,이경희 大韓口腔顎顔面 放射線學會 1999 Imaging Science in Dentistry Vol.29 No.2

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life, but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area, the lateral wall of the maxillary sinus, and the ascending ramus of mandible. MRI demonstrated a well defined mass of intermediate signal intensity in T1 weighted images but T2 weighted images showed two distinctive regions of different characteristics. Upper portion of the lesion was of hyperintense signal but (at) lower protion, the signal intensity decreased clearly, which might mean that this lesion(mass) is composed of two different subtypes though it couldn't be confirmed by histopathological examination. Biopsy was taken the lesion as only in the soft tissue of the maxillary posterior alveolar region and confirmed the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.(J Korean Oral Maxillofac Radiol 1999;29:533-548)

Unusual Course of the Accessory Meningeal Artery

Mi-Sun Hur(허미선),Ho-Jeong Kim(김호정),Kyu-Seok Lee(이규석) 대한체질인류학회 2012 해부·생물인류학 (Anat Biol Anthropol) Vol.25 No.4

이 연구의 목적은 관자아래우묵에서 아래턱신경에 대한 덧뇌막동맥의 해부학적 경로 변이를 기술하는데 있다. 덧뇌막동맥이 아래턱신경 뒤줄기의 표면을 지나가는 경우가 95세 남자 시신의 양쪽 관자아래우묵에서 관찰되었다. 덧되막동맥의 경로 및 주위구조와의 관계에 초점을 맞추어 해부하였다. 덧뇌막동맥은 중간뇌막동맥에서 일어났으며, 위쪽으로 올라가 아래턱신경 뒤줄기가 아래이틀신경과 혀신경으로 나누어지기 전의 신경 표면을 지나갔다. 그후, 덧뇌막동맥은 타원구멍으로 들어가기 전, 아래턱신경 앞줄기보다 깊게 지나갔으며, 아래턱신경 뒤줄기의 앞쪽으로 지나갔다. 덧뇌막동맥의 해부학적 경로 변이는 타원구멍과 관자아래우묵으로의 수술적 접근시 도움이 될 것으로 생각된다. This case report describes a variation in the course of the accessory meningeal artery relative to the mandibular nerve in the infratemporal fossa. An accessory meningeal artery running superficially to the posterior division of mandibular nerve was found bilaterally in the cadaver of a 95-year-old male. It was observed by a topographic examination followed by a detailed dissection. The accessory meningeal artery arose from the middle meningeal artery. It then passed upward and coursed superficial to the posterior division of the mandibular nerve before its division into the lingual and inferior alveolar nerves. The accessory meningeal artery subsequently ran deep and rostral to the anterior and posterior divisions of the mandibular nerve, respectively, before entering the foramen ovale. The variation in the course of the accessory meningeal artery described herein should be helpful for surgeons in approaches to the foramen ovale region and infratemporal fossa.

상악동 편평세포암종의 수술적 치료에 있어서 측두아래오목과 날개구개오목 절제의 의의

최재영(Jae Young Choi),김동영(Dong Young Kim),윤주헌(Joo Heon Yoon),최은창(Eun Chang Choi) 대한두경부종양학회 1999 대한두경부 종양학회지 Vol.15 No.1

Objectives: Maxillary cancer is notorious for its poor prognosis because it is usually detected lately and the majority of patients have advanced disease. Especially when the cancer extended to infratemporal fossa or pterygopalatine fossa it is very difficult to remove all the involved structure by conventional maxillectomy. In these cases we have used radical maxillectomy through lateral approach. We tried to figure out the clinical significance of this procedure. Material and Methods: This study retrospectively analyzed 23 patients with squamous cell carcinoma of the maxillary sinus who underwent surgical treatment for cure. Among them 17 patients(group A) were treated with initial surgery and 6 patients(group B) underwent salvage surgery after radiotherpy. Radical maxillectomy was performed in 12 patients and conventional total maxillectomy in 11 patients. Results: In group A, 3 out of 9 total maxillectomy case and none of 8 radical maxillectomy case were recurred. In group B one patient died of postoperative complication and among the other 5 patients only one out of 3 radical maxillectomy was salvaged and 2 total maxillectomy cases were died of intercurrent disease. Conclusion: Wide surgical dissection of pterygopalatine fossa and infratemporal fossa may improve the survival rate in patients with posterior wall invasion of maxillary sinus.

Infratemporal fossa approach: the modified zygomatico-transmandibular approach

Kim, Soung Min,Paek, Sun Ha,Lee, Jong Ho Korean Association of Maxillofacial Plastic and Re 2019 Maxillofacial Plastic Reconstructive Surgery Vol.41 No.-

Background: The infratemporal fossa (ITF) is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Due to its difficult approach, surgical intervention at the ITF has remained a heavy burden to surgeons. The aim of this article is to review basic skull base approaches and ITF structures and to avoid severe complications based on the accurate surgical knowledge. Methods: A search of the recent literature using MEDLINE (PubMed), Embase, Cochrane Library, and other online tools was executed using the following keyword combinations: infratemporal fossa, subtemporal fossa, transzygomatic approach, orbitozygomatic approach, transmaxillary approach, facial translocation approach, midface degloving, zygomatico-transmandibular approach, and lateral skull base. Aside from our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) trial, there have been very few randomized controlled trials. The search data for this review are summarized based on the authors' diverse clinical experiences. Results: We divided our results based on representative skull base approaches and the anatomy of the ITF. Basic approaches to the ITF include endoscopic endonasal, transzygomatic, orbitozygomatic, zygomatico-transmandibular, transmaxillary, facial translocation, and the midfacial degloving approach. The borders and inner structures of the ITF (with basic lateral skull base dissection schemes) are summarized, and the modified zygomatico-transmandibular approach (ZTMA) is described in detail. Conclusions: An anatomical basic knowledge would be required for the appropriate management of the ITF pathology for diverse specialized doctors, including maxillofacial, plastic, and vascular surgeons. The ITF approach, in conjunction with the application of microsurgical techniques and improved perioperative care, has permitted significant advances and successful curative outcomes for patients having malignancy in ITF.

두개골저부 종양에 대한 측두하와 접근법

이상평,권장구,황성규,함인석,박연묵,김승래,이상흔,박준식,조태환 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.6

The technique and results of infratemporal fossa approach of jugular foramen neuroma and clivus chordoma are presented. The infratemporal fossa approach allowed radical removal of jugualr foramen neuroma and effective palliative removal of clivus chordoma. The basic features of infratemporal fossa approach are permanent anterior displacement of the facial verve, subtotal petrosectomy and obliteration of the middle ear cleft.

측두하와에 발생한 활막 육종을 청력을 보존하면서 제거한 1예

신승국,우창기,남수봉,이윤세 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.7

Synovial sarcoma is a rare mesenchymal tumor that usually occurs in the extremities of young adults. Only 10% originates from the head and neck region, where the hypopharynx and retropharynx are the most common involved. Fewer than 100 cases of synovial sarcoma have been reported in this area. The infratemporal region, by virtue of its relatively concealed location, is a difficult site to access. It is considered a mainstay to design an appropriate technique to provide maximum exposure with minimal morbidity and preserve hearing ability, which may be achieved by the subtemporal-infratemporal fossa approach. We experienced a 50-year-old female patient who was suffering from right infratemporal fossa mass. We report this rare case that was successfully removed via this approach with a literature review.

[P442] Infratemporal fossa abscess: a rare, severe and misdiagnosed infection

( Min-young Park ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Moon-bum Kim ),( Byung-soo Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

A 76-year-old man presented with a 3 × 4 cm-sized protruding mass in the left preauricular area. Pain, tenderness, and trismus were present. Initial physical examination revealed swelling and tenderness on the left side of the face. Cervical lymphadenopathy was absent. No signs of neoplasia were observed on biopsy. MRI demonstrated massive inflammation in the left pterygoid, masseter muscle, and adjacent soft tissues, which were consistent with the diagnosis of Infratemporal fossa abscess (IFA). The patient was referred to the department of dental surgery to identify the origin of infection. Digital panoramic radiography showed no canine, premolars, or molars in the left mandible. On further investigation, he reported self-extraction of mobile teeth in the left mandible 5 months ago. He was admitted and prescribed intravenous antibiotic therapy for 4 weeks. The clinical outcome was found to be satisfactory. IFA is rare and its clinical diagnosis tends to be challenging owing to non-specific signs and symptoms. IFA has potentially fatal complications. Thus, ensuring minimal treatment time is crucial for its diagnosis and successful management. For timely diagnosis and appropriate management of IFA, thorough medical and dental history, oral, facial and systemic examination, radiographic and histopathologic findings and knowledge of the anatomical structures are needed.

측두하와에 발생한 혈관주위 세포종 1예

고태경,홍종철,정진숙,박헌수 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.8

Hemangiopericytoma is an uncommon vascular tumor in the head and neck region that originates from Zimmerman’s pericytes, the small, spindle-shaped pericapillary cells. Clinical diagnosis of such a lesion is an extremely challenging task because there are very few detailed reports of such lesions and one would hardly think of a diagnosis such as hemangiopericytoma while examining a lesion. Only 15% of hemangiopericytomas are localized in the cervicofacial region,with occurrence in the infratemporal fossa is particularly exceptional. In this article, we report an unusual case of hemangiopericytoma originating from the right infratemporal area and extending into the pterygomaxillary fissure, the buccal fat pad, and the hard palate. We present a case of infratemporal fossa hemangiopericytoma that was treated by resection of the transantral approach. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:511-4