{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:52:07Z","timestamp":1783774327493,"version":"3.55.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2007,9]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Achieving microscopically tumor-free margins during resection of skull base malignancies has consistently been identified as a positive prognostic factor for patient survival. When malignancies extend perineurally into the major nerves traversing the skull base and entering the cavernous sinus, achieving tumor-free margins can be challenging and typically necessitates performing a craniotomy to access the lateral wall of the cavernous sinus. This report describes a novel technique used to access and resect malignancy extending perineurally into the intracranial portion of V2 via the maxillary sinus.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Seven patients with maxillary sinus tumors and perineural extensions along V2, who underwent resection of the primary tumor and transmaxillary intracranial exposure and dissection of the maxillary nerve to achieve maximal tumor resection, were analyzed. Prospectively collected data, including symptoms, clinical signs, diagnostic imaging data, pathological diagnosis, incidence and nature of complications, adjuvant therapies, and oncological outcomes, were retrospectively analyzed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>All patients in this cohort had trigeminal nerve symptomatology as well as abnormal enhancement in the pterygopalatine fissure as noted on magnetic resonance imaging. The transmaxillary exploration of the maxillary nerve technique was used in all seven patients, resulting in gross-total resection of the tumors in every patient. At the last follow-up (mean 30 months, range 13\u201358 months, in four of seven patients for &gt; 2 years), six patients were alive without evidence of local disease. One patient with squamous cell carcinoma died of progressive infratemporal fossa and regional neck disease 26 months after resection. No intracranial or cavernous sinus disease was present.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This technique extended the limits of resection without the need for a craniotomy and improved local tumor control in this patient cohort.<\/jats:p><\/jats:sec>","DOI":"10.3171\/jns-07\/09\/0672","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:54:10Z","timestamp":1201179250000},"page":"672-677","source":"Crossref","is-referenced-by-count":23,"title":["Transmaxillary exploration of the intracranial portion of the maxillary nerve in malignant perineural disease"],"prefix":"10.3171","volume":"107","author":[{"given":"Franco","family":"DeMonte","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehab","family":"Hanna","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1070672","series-title":"Neurosurgery","first-page":"827","article-title":"Endoscopic endonasal cavernous sinus surgery: an anatomic study","volume":"48","author":"Alfieri","year":"2001"},{"key":"b2-1070672","series-title":"Ann Otol Rhinol Laryngol","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1177\/000348948509400420","article-title":"Nerves and neurotropic carcinomas","volume":"94","author":"Batsakis","year":"1985"},{"issue":"1","key":"b3-1070672","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations","volume":"19","author":"Cavallo","year":"2005"},{"issue":"1","key":"b4-1070672","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Extended endoscopic endonasal approach to the pterygopalatine fossa: anatomical study and clinical considerations","volume":"19","author":"Cavallo","year":"2005"},{"key":"b5-1070672","series-title":"Br J Plast Surg","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1054\/bjps.2001.3636","article-title":"Adenoid cystic carcinoma of the head and neck","volume":"54","author":"Chummun","year":"2001"},{"key":"b6-1070672","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1097\/00006123-199706000-00040","article-title":"Transmaxillary approach to the anterior cavernous sinus: a microanatomic study","volume":"40","author":"Couldwell","year":"1997"},{"issue":"5 Suppl","key":"b7-1070672","series-title":"AJNR Am J Neuroradiol","first-page":"S15","article-title":"Lymphomatous involvement of the trigeminal nerve and Meckel cave: CT and MR appearance","volume":"10","author":"De Pena","year":"1989"},{"key":"b8-1070672","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"667","DOI":"10.3171\/jns.1985.62.5.0667","article-title":"A combined epi- and subdural direct approach to carotid-ophthalmic artery aneurysms","volume":"62","author":"Dolenc","year":"1985"},{"key":"b9-1070672","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1177\/000348948509400420","article-title":"Use of preoperative MR to predict dural, perineural, and venous sinus invasion of skull base tumors","volume":"17","author":"Eisen","year":"1996"},{"key":"b10-1070672","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/0360-3016(95)00122-F","article-title":"The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation","volume":"32","author":"Garden","year":"1995"},{"key":"b11-1070672","series-title":"Crit Rev Neurosurg","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1177\/000348948509400420","article-title":"Perineural spread in head and neck and skull base cancer","volume":"4","author":"Hanna","year":"1994"},{"key":"b12-1070672","series-title":"Skull Base Surg","first-page":"15","article-title":"Sinonasal tumors: the Arkansas experience","volume":"8","author":"Hanna","year":"1998"},{"key":"b13-1070672","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1097\/00005537-200006000-00011","article-title":"Neural cell adhesion molecule expression in adenoid cystic carcinoma of the head and neck","volume":"110","author":"Hutcheson","year":"2000"},{"key":"b14-1070672","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1148\/radiology.174.1.2152985","article-title":"Perineural tumor extension through the foramen ovale: evaluation with MR imaging","volume":"174","author":"Laine","year":"1990"},{"key":"b15-1070672","series-title":"Am J Surg","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1016\/0002-9610(66)90309-6","article-title":"Perineural lymphatics: myth or fact","volume":"112","author":"Larson","year":"1966"},{"key":"b16-1070672","series-title":"RadioGraphics","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1148\/radiographics.11.3.1852933","article-title":"Clinical-radiologic issues in perineural tumor spread of malignant diseases of the extracranial head and neck","volume":"11","author":"Parker","year":"1991"},{"key":"b17-1070672","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1002\/cncr.11630","article-title":"Craniofacial surgery for malignant skull base tumors: report of an international collaborative study","volume":"98","author":"Patel","year":"2003"},{"key":"b18-1070672","series-title":"Head Neck","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1002\/(SICI)1097-0347(199908)21:5<402::AID-HED4>3.0.CO;2-Z","article-title":"The role of skull base surgery for the treatment of adenoid cystic carcinoma of the sinonasal tract","volume":"21","author":"Pitman","year":"1999"},{"key":"b19-1070672","series-title":"Am J Otolaryngol","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/S0196-0709(99)90028-5","article-title":"Risk factors for local recurrence of adenoid cystic carcinoma: the role of postoperative radiation therapy","volume":"20","author":"Prokopakis","year":"1999"},{"key":"b20-1070672","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1097\/00005537-200002010-00019","article-title":"Extradural extranasal combined transmaxillary transsphenoidal approach to the cavernous sinus: a minimally invasive microsurgical model","volume":"110","author":"Sabit","year":"2000"},{"key":"b21-1070672","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/S0090-3019(02)00764-4","article-title":"Modified infratemporal fossa approach via lateral transantral maxillotomy: a microsurgical model","volume":"58","author":"Sabit","year":"2002"},{"key":"b22-1070672","series-title":"Neurosurgery","first-page":"1311","article-title":"Comment on Couldwell et al: Transmaxillary approach to the anterior cavernous sinus: a microanatomic study","volume":"40","author":"Sekhar","year":"1997"},{"key":"b23-1070672","series-title":"J Oral Maxillofac Surg","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1053\/joms.2001.20986","article-title":"Treatment of carcinoma of the parotid gland: the results of a multicenter study","volume":"59","author":"Tullio","year":"2001"},{"key":"b24-1070672","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/S0194-5998(00)70203-8","article-title":"Correlation of neural cell adhesion molecules with perineural spread of squamous cell carcinoma of the head and neck","volume":"122","author":"Vural","year":"2000"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/107\/3\/article-p672.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/107\/3\/article-p672.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/107\/3\/article-p672.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T01:30:38Z","timestamp":1681349438000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/107\/3\/article-p672.xml"}},"subtitle":["Technical note"],"short-title":[],"issued":{"date-parts":[[2007,9]]},"references-count":24,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns-07\/09\/0672","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2007,9]]}}}