Tumors Involving the Infratemporal Fossa: A Systematic Review of Clinical Characteristics and Treatment Outcomes

Abstract

Background: Infratemporal fossa (ITF) tumors represent various pathologies and are seldom described in the literature, reflecting their rarity. Here we review the literature on tumors invading ITF and describe patient characteristics, treatment strategies, and clinical outcomes. Methods: Relevant articles were retrieved from PubMed, Scopus, and Cochrane. A systematic review and meta-analysis were conducted on the clinical presentation, treatment protocols, and clinical outcomes. Result: A total of 27 articles containing 106 patients with ITF tumors (median tumor size: 24.3 cm3 [interquartile range, 15.2–42 cm3]) were included (median age: 46 years [interquartile range, 32–55 years]; 59.4% were males]). Of the confirmed tumor pathology data, schwannomas (n = 24; 26.1%) and meningiomas (n = 13; 14.1%) were the most common tumors. Facial hypoesthesia (n = 22; 18.5%), auricular/preauricular pain (n = 20; 16.8%), and headaches (n = 11; 9.2%) were the most common presenting symptoms. Of patients who had surgical resection (n = 97; 95.1%), 70 (73.7%) had transcranial surgery (TCS) and 25 (26.3%) had endoscopic endonasal surgery (EES). Among available details on the extent of resection (n = 84), gross-total resection (GTR) was achieved in 62 (73.8%), and 5 (6.0%) had biopsy only. Thirty-five (33.0%) patients had postoperative complications. Among cases with available data on reconstruction techniques (n = 8), four (50%) had adipofascial antero-lateral thigh flap, three (37.5%) had latissimus dorsi free flap, and one (12.5%) had antero-lateral thigh flap. Fourteen (13.2%) patients had adjuvant chemotherapy, and sixteen (15.1%) had adjuvant radiotherapy. During a median follow-up time of 28 months (IQR, 12.25–45.75 months), 15 (14.2%) patients had recurrences, and 18 (17.0%) patients died. The median overall survival (OS) time was 36 months (95% confidence interval: 29–41 months), and the 5-year progression-free survival (PFS) rate was 61%. Conclusion: Various tumor types with different biological characteristics invade the ITF. The present study describes patient demographics, clinical presentation, management, and outcomes. Depending on the tumor type and patient condition, patient-tailored management is recommended to optimize treatment outcomes.

Infratemporal Fossa Schwannoma Surgery via a Combined Prelacrimal Recess, Caldwell-Luc, and Distal Intraoral Approach

“…Notably, open surgery carries a significantly higher complication rate compared with endoscopic surgery. 16 In this approach, both incisions only require a bone wall hole of the size typically used in endoscopic surgery, while the third approach is accessed through a natural space on the lateral side of the ITF. The endoscope operation process remains consistent with conventional endoscopic sinus surgery, thereby reducing learning costs.…”

“…It has been reported that approximately one third of patients undergoing surgery in the ITF experience surgical complications, with neurological impairment being the most common, including functional deficits in the lingual, inferior alveolar, and facial nerves. Notably, open surgery carries a significantly higher complication rate compared with endoscopic surgery 16 …”

Respiratory Epithelial Adenomatoid Hamartoma at an Unusual Location: A Case Report and Literature Review

“…In a previous study, clinical presentations of tumors within the infratemporal fossa, including the retromaxillary buccal fat pad, were mainly facial hypoesthesia, preauricular/auricular pain, headaches, and jaw deviation. Due to its concealed location, clinical signs and symptoms might present late and progress gradually ( 8 ). Furthermore, the buccal space is often underrepresented in the literature because of its small size and prevalence of adipose tissues ( 9 ).…”

Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in surgically resected schwannomas

“…Schwannomas are benign tumors that originate from Schwann cells of the cranial and peripheral nerves, and have a variable growth pattern (1). Clinical outcome after their surgical resection is related to extent of removal (2)(3)(4)(5)(6), which in the future could be assisted by new imaging modalities besides classic magnetic resonance imaging (MRI) (7).…”