Infratemporal fossa and pterygopalatine fossa

Core Procedures

Pathology in the Infratemporal and Pterygopalatine Fossae

• Biopsy

• Partial/selective excision

• Total clearance/compartment resection

• Route for more proximal surgery

Open Approaches

• Lateral

• Anterior

• Inferior

• Superior

• Combinations

Endoscopic Approaches

• Endonasal

• Transmaxillary

• Transpterygoid

• Combinations

The space behind the maxilla (retro-maxilla) and beneath the skull is principally occupied by the infratemporal fossa (ITF) and pteryogo­palatine fossa (PPF). These are well-defined spaces that contain masticatory muscles and neurovascular structures, including two parasympathetic ganglia. Their relative inaccessibility, contents and proximity to vital structures have made clinicians historically wary of dealing with pathologies in this area. However, improvements in imaging and advances in surgical techniques have rendered the ITF and PPF more accessible. The area is of interest to clinicians in several specialties, who access it through a variety of routes and who all need an in-depth knowledge of the relevant three-dimensional anatomy in order to undertake procedures safely and to avoid complications.