Buccopharyngeal fascia an overview sciencedirect topics. This region includes, in addition to the inferior part of the temporal and pterygoid muscles, the internal maxillary artery, the pterygoid venous plexus, and branches of the third division of the trigeminal nerve. Agreement regarding the exact anatomic boundaries of the infratemporal fossa itf has not been universal 8, 11, 14, 16, 20, 24, 27. Newly identified thin membranous tissue in the deep infratemporal.
Ct manifestation of abscess occupying the infratemporal. The infratemporal fossa is a surgically significant region. The infratemporal fossa lies at the boundary of the head and neck, and the intracranial cavity. Although the infratemporal region is well defined anatomically, its complex topography has been the subject of numerous, and sometimes, opposite works. Region infratemporal region palatina faringe y espacio perifaringco. In addition, more than 50 carefully selected radiologic images help bridge illustrated anatomy to living anatomy as seen in everyday practice. Ct manifestation of abscess occupying the infratemporal fossa and temporoparietal region in a 73yearold malecase report ewa zawislak and rafal nowak department of maxillofacial surgery, silesian piast medical university, poland. This case demonstrated foreign body retrieval which was impacted in the infratemporal region.
Surgical anatomy of the maxillary nerve in the zygomatic region. Subsequently, computed tomography showed a hyperdense image located among the maxillary tuberosity, the mandibular ramus, and the zygomatic bone, invading the right infratemporal space fig 1. Temporal region and infratemporal fossa objectives. The lower alveolar nerve, posterior terminal ramu of the mandibular nerve, is a mixed nerve that runs the infratemporal region until it penetrates the mandibular.
The purpose of this study was to report on the previously unknown and newly described membranous tissue in the deep infratemporal region, and add these new anatomical findings to the study of the pharynx region. Hydatidosis of infratemporal fossa with proptosis an. The world\u2019s most trusted clinically focused anatomy text. Infratemporal fossa, masticator space and parapharyngeal. Diagnosis of infratemporal fossa tumors using percutaneous. This type of anatomical knowledge is essential to choosing the best approach to treat lesions in this area. The purpose of this study was to report on the previously unknown and newly described membranous tissue in the deep infratemporal region. Cureus combined endonasaltranscervical approach to a. The buccopharyngeal fascia forms a distinct layer just up to the posterior part of the buccinator muscle and envelops the superior pharyngeal constrictor muscle. Infratemporal fossa abscess ifa can be misdiagnosed due to its rarity. The infratemporal fossa itf is an anatomic space of great importance1. While clinicians are familiar with infratemporal fossa itf, radiologists are familiar with masticator space ms.
Many muscular fibres of the buccinator muscle originate from this fascia, and then insert into the buccal fat pad and into the connective tissue of the lips. The infratemporal fossa is a concave region positioned behind the maxilla bone below the sphenoid and temporal bones and medial to the zygomatic arch. That is the reason why it appeared necessary for the authors to reevaluate this topic using the original method of combelles and boyer, allowing to define three referential planes, and thereby, a tridimensional shape and the volume of this. The surgeon perceives the head and neck region by realtime experience at surgery as a three. Some of the branches in this region are the inferior alveolar artery iaa and the buccal artery ba, both descending branches. We describe for the first time a combined endonasal and transcervical approach for a parapharyngeal metastasis from a papillary thyroid carcinoma. Region by region coverage, including muscle table appendices at the end of each. Combined infratemporal fossa and transfacial approach to. Can the radiologist and surgeon speak the same language. The infratemporal fossa communicates frontally with the tuberosity of the maxillary bone, superiorly with the temporal region, posteriorly with the parotid lodge, medially with the pterygopalatine fossa, and inferiorly with the pharynx fig. Endoscopic versus open approach to the infratemporal fossa. The infratemporal fossa, also known as infratemporal or zygomatic region, is a space normally not explorable because it is medial to the mandibular branch.
The posterior superior alveolar nerves are inferiorly oriented near the maxillary. It is not fully enclosed by bone in all directions, and it contains superficial muscles that are visible during dissection after removing skin and fascia. The infratemporal space also termed the infratemporal space or the infratemporal portion of the deep temporal space is a fascial space of the head and neck sometimes also termed fascial spaces or tissue spaces. Therefore, an infection in the infratemporal space is a potentially lethal condition2. The authors of this article believe that it is more appropriate to use the name infratemporal spine because of its position located on the edge of the infratemporal region and also its shape, which, in this sample, shows structures similar to bony spines with sharp edges pyramidal and spiniform laminar. Invasion of the medial and lateral pterygoid muscles, infratemporal fat and temporalis muscle is denoted as t4 disease and is usually found when tumors extend laterally from the parapharyngeal space, pterygoid base or the pterygomaxillary fissure. Preoperative ct imaging is a prerequisite for the diagnosis and accurate localization of the foreign body. The lateral surface of the greater wing of the sphenoid is convex, and divided by a transverse ridge, the infratemporal crest, into two portions the superior or temporal portion, convex from above downward, concave from before backward, forms a part of the temporal fossa, and gives attachment to the temporalis. V3 is the deepest structure in the infratemporal fossa. Together, these two uniquely talented physicianartists highlight the most clinically relevant views of the human body.
We realized microdissections of thirtytwo infratemporal and parotid regions of human cadavers formolfixed. It consists of a main trunk, an anterior division, and a larger posterior division. Head and neck involvement of echinococcosis is a rare entity and involvement of the infratemporal region is extremely rare even in. This approach to the infratemporal fossa is preferred to the more complicated external surgical approach with its greater risk of morbidity. Clase fosa temporal, infratemporal y pterigopalatina. Rouviere anatomia humana completo pdf a natomia ro uviere completo pdf descripcion. Microanatomy and surgical approaches to the infratemporal fossa. We conducted a routine dissection of both if in a 54yearold hispanic male cadaver. Descargar rouviere anatomia humana, 11 edicion 4 tomos. It is endemic in sheepraising and cattleraising areas worldwide and humans are an accidental intermediate host following the ingestion of the larvae. The signs and symptoms of an infratemporal space infection are swelling of the face in the region of the sigmoid notch, swelling of the mouth in the region of the maxillary tuberosity and marked trismus difficulty opening the mouth, since some of the muscles of mastication are restricted by the swelling. Histologic diagnosis of infratemporal fossa malignancy was obtained by needle biopsy of the foramen ovale region. The infratemporal fossa approach to the lateral skull base.
Introduction a knowledge of the anatomy of the infratemporal and temporal fossae and their contents is essential for understanding the dental region. Its limits are represented anteriorly by the maxillary tuberosity and the maxillary sinus, superiorly by the greater wing of the sphenoid bone and part of the temporal bone, medially by the lateral plate of the pterygoid process and the lateral wall of the pharynx. Other authors define the infratemporal region as the area under the floor of the middle fossa 16, 24. Infratemporal fossa and the temporomandibular joint. Region parotidea, temporal e infratemporal by naermy matos. Unimplemented annotation type freetext, falling back to base annotation.
It is a potential space in the side of the head, and is paired on either side. The resection includes the hemimandible and the soft tissues of the intratemporal fossa. University of michigan medical school s9 infratemporal. The infratemporal fossa itf is a deep quadrangular space inferior to the base of the middle cranial fossa. Hydatid disease is one of the common zoonotic diseases caused by the larval stage of echinococcus granulosus. Magnetic resonance imaging staging of nasopharyngeal. It contains major neurovascular structures and communicates with the orbit and middle cranial fossa. Newly identified thin membranous tissue in the deep.
Waters radiography initially showed a radiopaque image lateral to the maxillary tuberosity. This approach is occasionally complicated by morphological structures such as the. The case describes, that intralesional finger palpation could be a sensitive and. The major structure in the temporal fossa is the temporalis muscle.
Anatomical study of the pterygospinous and pterygoalar bony. A 60yearold man with a history significant for arteriosclerosis and hypertension presents with recent onset of periodic syncopal episodes. Start studying regiones parotidea, y temporal, fosa infratemporal y articulacion temporomandibular. Splitting the lip in the midline and developing a large cervicofacial flap gives an excellent exposure to the region. Twenty infratemporal fossa were dissected and examined using micro. The infratemporal fossa approach is commonly used for access to the lateral skull base as well as the parapharyngeal space. The origin, insertion and innervations of the tissue were subsequently thoroughly examined. Upon performing an angiogram, the physician notes significant stenosis of the internal carotid artery. Neoplastic processes involving the infratemporal fossa may originate from the tissues in the region, but more often are the result of extension from neighboring structures. The infratemporal fossa is an irregularly shaped cavity, situated below and medial to the zygomatic arch. This paper describes a case of limited mouth opening, secondary to facial trauma by cuttingincised object glass, whose fragments had not been diagnosed in the immediate posttrauma care, remaining in the region of the infratemporal fossa. Frequency and characterization of the infratemporal spine in a.
Written and edited by expert surgeons in collaboration with a worldrenowned anatomist, this exquisitely illustrated reference consolidates surgical, anatomical and technical knowledge for the entire human body in a single volume. This approach provides the surgeon with wide enough access to safely remove massive tumors, and it allows excellent control of the internal carotid artery without leaving facial scars. Infratemporal fossa, masticator space and parapharyngeal space. Here, we report an unusual unilateral origin of the iaa and the ba from a common trunk directly from the e ca. This approach provides the most direct access to the entire length of the skull base from the nasopharynx and parapharynx anteriorly as well as the foramen jugulare posteriorly. Robert acland presents moving structuresmuscles, tendons, and jointsmaking the same movements that they make in life. The aim of this study was to precise the relationships of the auriculotemporal nerve in the infratemporal and parotid regions. The maxillary nerve in the zygomatic region sends descendent branches to the soft tissue structures of this region and posterior superior alveolar branches, which descend contiguous to the maxillary tuberosity in variable numbers.
Nearly 23 of the extraosseous trajectory of the maxillary nerve is located in the zygomatic region. Unilateral variation in the origin of the inferior alveolar. The infratemporal fossa is delineated by the lateral pterygoid plate of the sphenoid bone and the. It is located posterior to the maxilla, between the lateral pterygoid plate of the sphenoid bone. The purpose of this study is to analyze the prevalence of ossification of these ligaments and assess morphometrically the ptery gospinous civininis and pterygoalar crotaphiticobuccinatorius foramens. The parapharyngeal space is bounded anteriorly by the masticator space, laterally by the deep parotid space, medially by the pharyngeal mucosal space, posteriorly by the carotid space, and posteromedially by the lateral extension of the retropharyngeal space. Despite these aids, accurate information requires a precise understanding of the different nomenclature of suprahyoid spaces used by the radiologist and clinician. Some authors refer to the itf as the region below the greater wing of the sphenoid bone 14, 27, lateral to the medial pterygoid muscle and the lateral pterygoid plate. The lateral transzygomatic infratemporal fossa approach is commonly used by. Although papillary thyroid carcinoma metastases to the parapharyngeal space are rare, the high amount of fat tissue allows tumors to grow clinically undetectable until they invade most of the parapharyngeal space. Tumor spread to the infratemporal fossamasticator space and hypopharynx. The infratemporal fossa borders contents teachmeanatomy.
Infratemporal definition of infratemporal by the free. Brs gross anatomy 9th edition pdf download usmlematerials. Microsurgical anatomy of the infratemporal fossa joo. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The infratemporal fossa approach, developed by fisch 106 in 1977, is a craniotemporocervical approach for exposure of the lateral inferior skull base. Carlson, md fasciae of the neck knowledge of the fascial layers of the neck is mandatory to extirpate cancer and treat infections of the head and neck. Frequency and characterization of the infratemporal spine. The infratemporal fossa is a complex area located at the base of the skull, deep to the masseter muscle it is closely associated with both the temporal and pterygopalatine fossae and acts as a conduit for neurovascular structures entering and leaving the cranial cavity this article will outline the borders and content of the fossa before examining its clinical relevance.
T2p involvement of parapharyngeal region t3a bony involvement below the skull base including the floor of sphenoid t3b involvement of skull base t3c cranial nerves involvement t3d orbit, laryngopharynx, infratemporal fossa t3p parapharyngeal region regional nodes n n0 no nodes n1 nodes above skin crease at laryngeal. Massive tumors of the infratemporal and pterygopalatine fossa are usually resected via the fisch type c infratemporal fossa approach. Aclands video atlas of human anatomy contains nearly 330 videos of real human anatomic specimens in their natural colors, including 5 new, groundbreaking videos of the inner ear. Infratemporal fossa an overview sciencedirect topics.
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