Zygomatic swing approach to the infratemporal fossa


Infratemporal and pterygopalatine fossas are difficult to access surgically, and numerous approaches have been described and sometimes combined.1 To the best of our knowledge, maxillary swing was first described by Hernán- dez Altemir in 19862 as an alternative access to infratemporal tumours. It opens the maxillozygomatic complex like a book (in a similar way to the mandibular swing technique), which leaves it vascularised through the facial skin that had been left attached, and it leads to good open visualisation and access of the infratemporal fossa. Morbidity is low compared with other approaches (hearing deficiency and facial palsy in lateral approaches, and facial palsy and issues with masti- cation in transmandibular inferior approaches). Endoscopy is another alternative for removal, although it is limited to medial tumours and en bloc resection is impossible. 

We present a technique of modified zygomatic swing that does not involve the hard palate, and describe its use in the removal of a malignant tumour of the infratemporal fossa in an 18-year-old woman who had no available medical history. 

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