Endoscopic transnasal approaches to pterygopalatine fossa tumours

Background. The pterygopalatine fossa (PPF) is a difficult area to access, traditionally treated by external approaches. The development of endoscopic transnasal approaches enables to reach this region through a minimally invasive route, reducing the associated morbidity. Methods. Retrospective review of patients with benign and malignant tumours arising in or extending to the PPF, treated from 2000 to 2013 at a single Institute, using endoscopic transnasal transmaxillary approaches. Results. Thirty-seven consecutive patients with benign (27 cases) and malignant (10 cases) tumours were treated with curative intent. Radical resection was achieved in 36/37 patients. No major complications were observed. No local recurrences were observed, with a median follow-up of 38.5 months for malignancies and 60 months for benign tumours. Conclusions. The endoscopic transnasal approaches are safe and feasible techniques for the radical resection of selected tumours involving the PPF and should be tailored according to the biology and extension of the lesion.