Infratemporal fossa approach type a with transcondylar‐transtubercular extension for Fisch type C2 to C4 tympanojugular paragangliomas

Abstract

The transcondylar-transtubercular extension of the classic IFTA-A is aimed at making the excision of Fisch type C2 to C4 tympanojugular paragangliomas simpler and safer by drilling out one third of the lateral part of the occipital condyle and removing the jugular process and jugular tubercle.

Strategies and long‐term outcomes in the surgical management of tympanojugular paragangliomas

“…Surgical management of tympanojugular paragangliomas has steadily yielded better results over the last couple of decades after the description of the Fisch infratemporal fossa approach by Moe et al and the addition of extensions to it . The introduction of techniques, like the intra‐arterial stenting of the ICA at our center in 2003, have made surgery possible even in cases that were previously considered inoperable.…”

“…The transcondylar‐transtubercular extension of the classic infratemporal fossa approach type A developed at our center in 2006 is aimed at making the excision of class C2 to C4 tympanojugular paragangliomas simpler and safer by drilling out one third of the lateral part of the occipital condyle after removing the jugular process and jugular tubercle (see Figure ). The techniques are described in detail elsewhere . The classic infratemporal fossa approach type A permits superior and anterior exposure of the jugular foramen.…”

The Role of Wait-and-Scan and the Efficacy of Radiotherapy in the Treatment of Temporal Bone Paragangliomas

“…With the development of infratemporal fossa approaches (38) for skull base tumors and the transcondylarYtranstubercular extensions (39), it is now possible to envision and precisely remove even large tumors in this area with minimal morbidity and mortality. Preoperative intravascular neuroradiological interventions like preoperative balloon occlusion and protective stenting (of the internal carotid artery and/or the vertebral artery) have helped eliminate the potential risks associated with arterial involvement, which is often the case in TBPs (17,18,40).…”

The relationship between the carotid canal and mandibular condyle: an anatomical study with application to surgical approaches to the skull base via the infratemporal fossa

“…It is an important landmark as this area is simple to identify and often encountered during access osteotomies. [1,[29][30][31] …”

“…This segment is found inside the carotid sheath with the internal jugular vein lateral to the artery, and the vagus nerve usually in a posterolateral course. [1] Inside the carotid sheath, the ICA is surrounded by areolar tissue containing fat, a venous plexus, and postganglionic sympathetic nerves. Rostrally, as the ICA enters the carotid canal, the carotid sheath divides into two layers.…”