{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:46:24Z","timestamp":1792064784307,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The temporomandibular joint (TMJ) region is the most superolateral aspect of exposure via an endonasal corridor, while studies regarding the endonasal approach to this specific region are lacking. This study aimed to provide a detailed step\u2010by\u2010step surgical technique to reveal the medial aspect of the TMJ region on cadaveric dissection, and to retrospectively review endonasal removal of tumors in this specific region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cadaveric dissection was performed on 4 specimens to illustrate the surgical technique of endonasal access to the medial aspect of the TMJ region. Radiological measurement of distances from anterior nasal spine (D1), lateral pterygoid plate (D2), and foramen ovale (D3) to medial TMJ of bilateral sides on 100 continuous CT scans was performed. Five patients harbored tumors at the medial aspect of the TMJ region who underwent endonasal tumor removal were included in the study. The feasibility, perioperative morbidities, and clinical outcomes were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The contents at the medial aspect of TMJ region could be adequately exposed via an endonasal corridor on all 8 cadaveric sides. The average distances of D1, D2, and D3 were 88.20\u2009\u00b1\u20098.2\u2009mm, 22.80\u2009\u00b1\u20093.4\u2009mm, and 19.93\u2009\u00b1\u20091.73\u2009mm, respectively. The pathologies were osteoblastoma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092) and chemotherapeutic malignancies (one with osteosarcoma and two with rhabdomyosarcoma). Gross total resection was achieved in all five patients. A comprehensive treatment strategy was performed for 3 patients with malignancies. Postoperative trismus was encountered, while it gradually improved with minimal impact on quality of life. With an average follow up of 24.4\u2009\u00b1\u20099.84\u2009months, no recurrence was detected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It is feasible to perform an endonasal approach to the medial aspect of the TMJ region. For select tumors, an endonasal approach can serve as a viable option for tumor removal with few complications in experienced hands.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70521","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:50:40Z","timestamp":1792061440000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Endonasal Approach to the Medial Aspect of the Temporomandibular Joint Region"],"prefix":"10.1002","author":[{"given":"Jun","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery The Second Affiliated Hospital of Anhui Medical University  Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiujuan","family":"Kou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2902-4407","authenticated-orcid":false,"suffix":"Jr","given":"Nyall R.","family":"London","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0114-7608","authenticated-orcid":false,"given":"Lifeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"S145","article-title":"ICAR: Endoscopic Skull\u2010Base Surgery","volume":"9","author":"Wang E. 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V.","year":"2022","journal-title":"Journal of Craniofacial Surgery"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"3755","DOI":"10.1002\/hed.25906","article-title":"Surgical Approaches for Infratemporal Fossa Tumor Resection: Fifteen Years' Experience of a Single Center","volume":"41","author":"Yafit D.","year":"2019","journal-title":"Head & Neck"},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.wneu.2018.11.202","article-title":"Ultrasonic Scalpel\u2010Assisted Endoscopic Endonasal Surgery of Infratemporal Fossa: Our First Impressions","volume":"123","author":"Bozkurt G.","year":"2019","journal-title":"World Neurosurgery"},{"key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1093\/ons\/opy051","article-title":"Minimally Invasive Exposure of the Maxillary Artery at the Anteromedial Infratemporal Fossa","volume":"16","author":"Rodriguez Rubio R.","year":"2019","journal-title":"Operative Neurosurgery"},{"key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.anl.2024.09.004","article-title":"Endoscopic Surgical Management of Juvenile Nasopharyngeal Angiofibroma: Correlating Tumour Characteristics, Risk of Hemorrhage, and Recurrence","volume":"51","author":"Garc\u00eda\u2010Fern\u00e1ndez A.","year":"2024","journal-title":"Auris, Nasus, Larynx"},{"key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"e138","DOI":"10.1055\/s-0040-1701221","article-title":"Sinonasal Osteosarcoma: Report of 14 New Cases and Systematic Review of the Literature","volume":"82","author":"Low C. 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G.","year":"2012","journal-title":"Journal of Oral and Maxillofacial Surgery"},{"key":"e_1_2_9_28_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jormas.2023.101404","article-title":"Extended Total Temporomandibular Joint Reconstruction Prosthesis: A Comprehensive Analysis","volume":"124","author":"Khattak Y. R.","year":"2023","journal-title":"Journal of Stomatology, Oral and Maxillofacial Surgery"},{"key":"e_1_2_9_29_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s13256-019-1975-1","article-title":"A Modified Preauricular and Transmandibular Approach for Surgical Management of Osteosarcoma of the Mandibular Condyle Within the Masticator Space and Infratemporal Fossa: A Case Report","volume":"13","author":"Noguchi T.","year":"2019","journal-title":"Journal of Medical Case Reports"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70521","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.70521","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:50:44Z","timestamp":1792061444000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.70521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":28,"alternative-id":["10.1002\/hed.70521"],"URL":"https:\/\/doi.org\/10.1002\/hed.70521","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"assertion":[{"value":"2025-12-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hed.70521"}}