caa a22 4500 606213910 CHVBK 20210128101049.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00701-015-2402-z doi (NATIONALLICENCE)springer-10.1007/s00701-015-2402-z Combined endonasal and sublabial endoscopic transmaxillary approach to the pterygopalatine fossa and orbital apex [Elektronische Daten] [Maysam Alimohamadi, Mohamadreza Hajiabadi, Venelin Gerganov, Rudolf Fahlbusch, Madjid Samii] Background: The pterygopalatine fossa (PPF) and inferomedial orbital apex are difficult regions for open neurosurgical access. The traditional extensive anterior approach (transfacial or transmandibular) and lateral/posterolateral (transcranial) approach were used to access the PPF. The combined endonasal and sublabial transmaxillary approach is a less invasive access route for these lesions. In this study, we present the technical and clinical details of our experience with the combined endoscopic endonasal and transmaxillary approach. Methods: A retrospective analysis of our patients operated on using a combined endoscopic endonasal and transmaxillary approach was done. The preoperative, intraoperative and postoperative images and all the clinical data were evaluated. The accessibility to the area and extent of surgical resection were reviewed. The surgery-related complications and postoperative morbidities were analyzed. The main items of interest were the exposure of the target area and possibility for safe removal. Results: Five patients with pathologies located in the area of the PPF and orbital apex were operated on using the combined endoscopic sublabial and endonasal transmaxillary approach. The technique provided sufficient exposure of the area and allowed for safe removal of the preoperatively determined target in all of the patients. One patient developed dry eye and a neurotrophic corneal ulcer, and another patient developed temporary postoperative facial numbness. In the follow-up, only one patient with skull base chordoma had an asymptomatic tumor regrowth. The other patients had no recurrence or regrowth. Conclusions: The combined endoscopic sublabial and endonasal transmaxillary approach is a safe and effective method for resection of lesions in the PPF and inferomedial orbital apex. Springer-Verlag Wien, 2015 Skull base nationallicence Endoscopic nationallicence Infratemporal fossa nationallicence Orbital apex nationallicence Pterygopalatine fossa nationallicence Sublabial nationallicence Transmaxillary nationallicence Alimohamadi Maysam International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut Hajiabadi Mohamadreza International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut Gerganov Venelin International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut Fahlbusch Rudolf International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut Samii Madjid International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut Acta Neurochirurgica Springer Vienna 157/6(2015-06-01), 919-929 0001-6268 157:6<919 2015 157 701 https://doi.org/10.1007/s00701-015-2402-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2402-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Alimohamadi Maysam International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Hajiabadi Mohamadreza International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Gerganov Venelin International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Fahlbusch Rudolf International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Samii Madjid International Neuroscience Institute, Rudolf Pichlmayr Street, No. 4, 30625, Hannover, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/6(2015-06-01), 919-929 0001-6268 157:6<919 2015 157 701