Open and endoscopic approaches to the infratemporal fossa

The infratemporal fossa is a complex space that both contains and is closely associated with vital neurovascular structures. As such, surgical access of the infratemporal fossa presents a definitive challenge requiring complete understanding of ventral skull base anatomy and expertise with both open craniofacial and endoscopic techniques. Anterior and lateral approaches to the infratemporal fossa vary greatly and may be individualized to each case in order to optimize visualization and instrumentation. Significant progress has been made in the development of surgical techniques for treatment of tumors involving the infratemporal fossa, including expanded endonasal approaches. Endoscopic, minimally invasive, and open approaches each provide distinct advantages and disadvantages. In the present article, we will review indications and limitations of the varied methodology for approaching the infratemporal fossa.