BACKGROUND The surgical removal of the infratemporal parapharyngeal lesions (IPL) is challenging due to its anatomical complexity. Previous surgical approaches have often been too invasive and necessitated sacrifice of normal function and anatomical structures, particularly in the retromandibular nerve region. Therefore, we sought to identify an approach corridor to this area that requires less sacrifice and report an innovative approach through a retromandibular fossa route to the IPL. METHODS Five cadaveric specimens were dissected bilaterally with a trans-tympanic plate and styloid process approach. These specimens were investigated microanatomically and morphometrically to examine the extent of the approach in the parapharyngeal space. The clinical application of this approach was compared to previous approaches to the IPL used in our clinical series of 20 cases. RESULTS Using this novel approach, the inferior alveolar nerve was identified in all specimens, while the chorda tympani and lingual nerve were identified in 6 (60%) and 4 (40%) dissections, respectively. In all specimens, the petrous portion of the internal carotid artery and the exit of the lower cranial nerve were identified. The average length of the exposed lower cranial nerves was 16.6 ± 3.8 mm (range: 11-25 mm). CONCLUSIONS The described approach is feasible for accessing the IPL at the retromandibular nerve and is less invasive than conventionally used approaches.

中文翻译：

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耳前颌下跨鼓板和茎突突锁孔入路治疗咽旁病变：一项实验室研究。

背景技术由于其解剖学上的复杂性，颞下咽旁病变（IPL）的手术切除是具有挑战性的。以前的外科手术方法通常过于侵入性，必须牺牲正常功能和解剖结构，尤其是在下颌后神经区域。因此，我们试图确定需要较少牺牲的通往该区域的通道，并通过下颌后窝通往IPL的路线报告一种创新方法。方法采用鼓膜板和茎突处理方法，双侧解剖5例尸体标本。对这些标本进行了显微解剖和形态计量学研究，以检查咽旁间隙的进近程度。将该方法的临床应用与我们在20例临床系列中使用的IPL的先前方法进行了比较。结果使用这种新颖的方法，在所有标本中均鉴定出了下牙槽神经，而分别在6例（60％）和4例（40％）的解剖中鉴定了鼓膜鼓室和舌神经。在所有标本中，均识别出颈内动脉的小部分和下颅神经的出口。暴露的下颅神经的平均长度为16.6±3.8毫米（范围：11-25毫米）。结论所描述的方法对于在下颌后神经接近IPL是可行的，并且与常规方法相比具有较小的侵入性。分别在6处（60％）和4处（40％）解剖中发现了鼓膜鼓室和舌神经。在所有标本中，均识别出颈内动脉的小部分和下颅神经的出口。暴露的下颅神经的平均长度为16.6±3.8毫米（范围：11-25毫米）。结论所描述的方法对于在下颌后神经接近IPL是可行的，并且与常规方法相比具有较小的侵入性。分别在6处（60％）和4处（40％）解剖中发现了鼓膜鼓室和舌神经。在所有标本中，均识别出颈内动脉的小部分和下颅神经的出口。暴露的下颅神经的平均长度为16.6±3.8毫米（范围：11-25毫米）。结论所描述的方法对于在下颌后神经接近IPL是可行的，并且与常规方法相比具有较小的侵入性。