Diagnosis and surgical management of tumors primarily in the pterygopalatine fossa / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To evaluate the clinical features of tumors primarily in the pterygopalatine fossa, and the efficiency of surgical management for these lesions. METHODS The clinical data of 7 cases with tumors primarily in the pterygopalatine fossa were retrospectively studied. Three of them were primary diseases, i.e. fibrous histiocytoma, neurofibroma and cholesteatoma. The other 4 cases were secondary tumors mainly located in pterygopalatine fossa. There were 1 case with epithelial-myoepithelial carcinoma, 1 case with adenoid cystic carcinoma , 1 case with recurrent inverted nasal papilloma, 1 case with recurrent malignant fibrous histiocytoma. Approaches to tumors in pterygopalatine fossa lesions included lateral rhinotomy, and transnasal or transantrum approaches under the nasal endoscope. RESULTS The patient suffered from adenoid cystic carcinoma developed local recurrence 4 months after operation, and extended resection of the recurrent tumor with laser was performed again. No further recurrence was found after following-up for 3 years. Neither local recurrence nor regional metastasis was found in the remaining 6 cases with a follow-up period of 2 to 4 years. The main complication was oronasal fistula. CONCLUSION CT scan or MRI is the main method to the early diagnosis of pterygopalatine fossa tumors. Lateral rhinotomy, endoscopic trasnnasal or transantrum approaches are feasible procedures to resect the tumors.