Survival Outcomes of Infratemporal Fossa Tumors: Single Institution Experience

Purpose: To express our institutional experience with Infratemporal Fossa (ITF) tumors in terms of the postoperative complications and survival outcomes.

Methods: Patients with malignant tumors involving the ITF were identified and their demographics and treatment data were retrieved from the medical records, after obtaining Institutional Review Board approval. The recruited data include age, sex, race, date of diagnosis, histopathological diagnosis, details of surgical treatment (strategy and approach), surgical complications, and follow up. Pooled Overall (OS) survival and recurrence-free survival (RFS), as well as, Univariate and Multivariate Cox Proportional Hazards models were utilized. p < 0.05 was used to determine the required level of significance.

Results: We found 46 patients included in this cohort. They were treated at Augusta University from 2010–2014. The most common sites were maxilla (13), oral cavity (12), salivary glands (9), and nose/nasopharynx (4). The most common pathologies were SCC (39, 84.7%), and malignant melanoma (2, 2.2%). The following surgical approaches were utilized: preauricular (18), transnasal (10), transmaxillary (7), postauricular infratemporal approach (4), transoral(2), transcervical (2), transzygomatic (2), and transmandibular (1). Surgical complications in this cohort occurred in 12/46 patients (26%): infection (2), Fistula (2), flap failure (2), VPI symptoms (1), dysphagia (2), bleeding (1) and trismus (1). The median follow up was 18.3 months. Two and 5 year overall survival (OS) were 86% and 62%, respectively. Recurrence-free survival (RFS) rate at 2- and 5 years were 68% and 29%, respectively. Sub-analysis of survival data for SCC group alone showed poorer 5 year OS (52%), whereas 2 year OS and DFS remain the same. Univariate analysis revealed that age alone was associated with better survival (p = 0.0005). While Multivariate Cox Regression analysis failed to identify any single significant factor.

Conclusion: Proper surgical management of the extensive infratemporal fossa tumors provides acceptable morbidity and excellent survival outcome. However, its impact on survival requires a longer follow up period and larger patient cohort.