Pterygopalatine Fossa Tumors: Types and surgical approaches. Quito - Ecuador (in Spanish)

Abstract

INTRODUCTION: The pterygopalatine fossa (PPF) is an anatomical area that is difficult to access, and when presenting tumor masses there is a high risk of morbidity and mortality in both juvenile and adult populations. OBJECTIVES: To evaluate the types of approach used in surgical management, to analyze its complications and to identify the histological lineage of the lesions. MATERIALS AND METHODS: Retrospective descriptive study of patients operated on at Hospital Especialidades Carlos Andrade Marín in the period from January 2017 to December 2020, with imaging, endoscopic and histopathological findings of tumors with invasion to PPF that were divided into two groups: A) resection of tumor mass and B) biopsy of tumor mass. RESULTS: 29 patients were analyzed, 82.7% male, with an average age of 30.6 years. 82.8% of the tumor masses originated in the nasopharynx with extension towards FPP. The most frequent tumor was Juvenile Nasopharyngeal Angiofibroma (69%), Nasopharyngeal Carcinomas, Cystic Adenoid and Maxillary Sinus Sarcoma (20.7%), Invasive Brain Tumors (6.9%) and Invasive Mucocele (3.4%). In 62% of cases, the tumor invaded the Infratemporal Fossa (FIT) and in 41.4% it presented extension towards the sphenoid. The resection in 75.8% was endoscopic technique, both uni (24%) and multiportal (76%) and the remaining 24.2% by open technique partial maxillectomy by lateral rhinotomy and denker. Regarding associated complications, there was facial hyposensitivity in 10.3% of cases. CONCLUSION: All the cases analyzed had extension towards FPP and benign tumors were the ones that predominated. Both single and multiportal endoscopic approaches were effective for radical resection of benign masses, and open approaches were present for invasive malignant tumors.