278 Original article Clinical implications of transpterygoid approach to mandibular nerve Ahmed Youssefa,b, Ricardo L. Carraub, Shahzad Ahmedc, Ahmed Tantawya, Ahmed Aly Ibrahima, Abdulaziz Al Azric, Mohamed Zahrana aDepartment of Otolaryngology-Head and Neck Background Surgery, Alexandria University, Alexandria, The endonasal transpterygoid approach has been very popular as a standard Egypt, bDepartment of Otolarynglogy-Head and Neck Surgery, OHIO State University approach to the pterygopalatine and infratemporal fossa. However, its implications Wexner Medical Center, Columbus, Ohio, USA, actually extend beyond these regions to include access to the middle cranial fossa cDepartment of Otolaryngology-Head and Neck and parapharyngeal space. Surgery, University Hospital Birmingham, Objective Birmingham, UK The aim was to illustrate the anatomical landmarks of the endoscopic Correspondence to Ahmed Sobhy Youssef MD, transpterygoid approach especially the mandibular nerve and clinical implication PhD,MRCS, Head & Neck/Reconstructive of this approach through illustrated case presentation. Fellow-University of Newcastle, NSW-Australia, Materials and methods 2305; Clinical Fellow Head & Neck/Skull Base Surgery, University Hospital Birmingham, A cadaveric study was performed on three cadaveric adult specimens. Endoscopic Birmingham, UK; Lecturer Otolaryngology & medial maxillectomy, Sturman Canefield approach, and completion of Head and Neck Surgery-Faculty of Medicine- transpterygoid approach were done to visualize the different anatomical Alexandria University, Egypt, 2131. Tel: +20 landmarks, especially the mandibular nerve. An example of clinical application 111 000 3881; e-mails:
[email protected], Ahmed. of transpterygoid approach is an illustrated case to biopsy a perineural spread of
[email protected], Ahmed.Youssef@hnehealth. squamous cell cancer along the mandibular nerve in the lateral wall of cavernous nsw.gov.au sinus.