Endoscopic Modified Endonasal Denker Operation for Management of Tumor in Pterygopalatine and Infratemporal Fossae

Background and Aim: Although endoscopic approaches allow good visualization and access for many areas of the skull base, the lesions in the pterygopalatine fossa (PPF) and infratemporal fossa (ITF) are a challenge for otolaryngologists. The aim of our report is to describe an endoscopic modified endonasal Denker operation for the treatment of nonmalignant tumors in the PPF and ITF.

Material and Methods: From January 2004 to June 2007, five patients who had tumors in the PPF and/or ITF and underwent surgical resection of the tumors with the endoscopic modified endonasal Denker operation were reviewed regarding demographics, preoperative images, tumor cell type, surgical techniques, and outcomes.

Results: Five patients underwent the procedure (3 women and 2 men with a mean age of 38 and an age range of 21–58 years). All patients had adequate exposure and total tumor resection with the endoscopic modified endonasal Denker operation. None of the patients required an external approach for tumor extirpation. There were no major postoperative complications. Transient epiphora and hypoesthesia in the infraorbital nerve distribution resolved fully in all affected patients.

Conclusion: The endoscopic modified endonasal Denker operation for the management of lesions of the PPF and ITF provides excellent exposure and results with good hemostasis and low morbidity. This approach is a viable alternative to the open approaches to these areas.