{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:24:15Z","timestamp":1792099455297,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,8,26]],"date-time":"2014-08-26T00:00:00Z","timestamp":1409011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To propose a clinically applicable anatomic classification system describing three progressive endoscopic endonasal approaches (EEAs) to the infratemporal fossa (ITF) and their potential sequelae. Overall feasibility and outcomes of these approaches are presented through a consecutive case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Description of classification system for EEAs to the ITF and case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A classification system of EEAs to ITF tumors was created based on the senior author's clinical experience and cadaveric dissection. A retrospective chart review of 21 child and adult patients with primary ITF tumors treated by these approaches from 2008 to 2012 at a tertiary\u2010care academic medical center was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three progressive EEAs to ITF tumors were defined: 1) a transpterygopalatine fossa approach, 2) a transmedial pterygoid plate approach, and 3) a translateral pterygoid plate approach. Twenty\u2010one patients treated with these approaches were identified consecutively, with a mean age of 44.2 years (range, 11\u201379 years). Tumors primarily involving the pterygopalatine fossa and not the ITF were excluded. Pathology included three advanced juvenile nasopharyngeal angiofibromas, three adenoid cystic carcinomas, two recurrent inverted papillomas, two trigeminal schwannomas, and 11 other diverse skull base pathologies. No intraoperative or postoperative complications occurred, with a mean follow\u2010up of 21.5 months (range, 1\u201355 months). Expected potential sequelae such as V2\/palatal numbness, Eustachian tube dysfunction, and trismus occurred in 10\/21 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EEAs to ITF tumors are technically feasible with low risk of complications for well\u2010selected patients. The proposed classification system is useful for anticipating potential sequelae for each approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 124:2443\u20132450, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24638","type":"journal-article","created":{"date-parts":[[2014,2,8]],"date-time":"2014-02-08T09:36:12Z","timestamp":1391852172000},"page":"2443-2450","source":"Crossref","is-referenced-by-count":46,"title":["Endoscopic endonasal approaches to infratemporal fossa tumors: A classification system and case series"],"prefix":"10.1002","volume":"124","author":[{"given":"Robert J.","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A.","family":"Wheless","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kibwei A.","family":"McKinney","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Stadler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of North Carolina at Chapel Hill 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