Anatomic Study of Endoscopic Minimally Invasive Lateral Approach to the Infratemporal Fossa

Objective: To investigate the feasibility and related anatomical structures of the infratemporal fossa (ITF) through minimally invasive endoscopic lateral approach, so as to provide anatomical data and basis for clinical surgery. Methods: Six adult cadaveric heads were used to simulate the surgical dissection of the ITF through a minimally invasive endoscopic lateral approach, and the important vessels, nerves, and other structures in the surgical pathway and the surrounding adjacent relationships were observed, and relevant pictures were collected. Results: The maxillary arteries of 6 cadaver specimens (12 sides) were located on the surface of the lateral pterygoid muscle in 9 cases, and between the upper and lower heads of the lateral pterygoid muscle in 3 cases, constant branches were the deep temporal artery, pterygoid artery, masseter artery, and buccal artery. The superior posterior alveolar nerve branches off V2 in the ITF and descends along with its accompanying artery by the posterior wall of the maxilla. The buccal nerve branches out from the mandibular nerve and passes between the superior and inferior pterygoid muscles, runs anteriorly between the temporalis and lateral pterygoid muscle, and innervates the buccal muscles. Conclusion: The endoscopic minimally invasive lateral approach can expose the important structures, such as vessels and nerves related to the ITF well, and can be used as a minimally invasive surgical approach to treat the lesions of the infra- temporal fossa; it can also assist the endoscopic anterior approach to treat a series of lesions extending from the deep part of the pterygopalatine fossa to the posterior lateral side of the ITF.