Nasal Cavity 19 Nasopharynx 23 Extra-nasopharyngeal extension with multiple sinus involvement combination: Sphenoid 19 Ethmoid 9 Maxillary antrum 7 Pterygopalatine fossa
10 Infra-temporal fossa 6 Cheek and temporal fossa 3 Orbit 1 Intracranial extension 3 Table 8.
infiltration through the greater palatine foramen: where to bend the needle.
The pattern seen on contrast-enhanced CT is an intensely stained lesion in the nasopharynx with widening of the pterygopalatine fossa
The posterolateral wall of the antrum was then removed, leaving the maxillary sinus, nasal cavity, pterygopalatine fossa
, and nasopharynx as a single large cavity that communicated with the infratemporal fossa through the narrow pterygomaxillary fissure.
Many studies have indicated that JNA originates in the pterygopalatine fossa
at the aperture of the pterygoid canal.
Tumor spreads into pterygopalatine fossa
through inferior orbital fissure and from ethmoid labyrinth through medial orbital wall.
11) For example, patients with orbital tumors generally have a better prognosis than do patients with tumors in parameningeal sites (the nasopharynx, middle ear, mastoid area, paranasal sinuses, pterygopalatine fossa
, and parapharyngeal space).
In this approach, the most lateral portion of the sphenoid sinus is accessed through the posterior wall of the maxillary sinus and the pterygopalatine fossa
Computed tomography (CT) revealed that the tumor had invaded the left pterygopalatine fossa
, the infratemporal fossa, and the skull base with infiltration of the petrous portion of the left temporal bone and the left cavernous sinus (figure 3).
Computed tomography of the head and neck identified a 5 x 3 x 2-cm mass that involved the maxilla and hard palate and extended into the pterygopalatine fossa
, the posterior wall of the maxillary sinus, and the left nasal cavity.
The patient was treated successfully via a unique endoscopic transpterygoid app roach--that is, an endoscopic approach through the maxillary sinus and pterygopalatine fossa
and into the pterygoid process.
More advanced lesions might require orbital exenteration, pterygopalatine fossa
resection, or skull base resection.