Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection

Shuai Chen; Bowen Yang; Xiaobo Dai; Guanru Wang; Xingzhi Zeng; Yonglin Song; Guiquan Zhu; Chunjie Li; Bing Yan

doi:10.3791/68672

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Medicine

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JoVE Journal Medicine

Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection

侧磨牙入路驱动的经口内窥镜手术用于良性颞下窝肿瘤切除术

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04:04 min

August 15, 2025

DOI: 10.3791/68672-v

Shuai Chen^1,2, Bowen Yang^1,2, Xiaobo Dai^1,2, Guanru Wang^1,2, Xingzhi Zeng^1,2, Yonglin Song¹, Guiquan Zhu^1,2, Chunjie Li^1,2, Bing Yan^1,2

¹State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology,Sichuan University, ²Department of Head and Neck Oncology, West China Hospital of Stomatology,Sichuan University

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在这里，我们提出了一种通过内窥镜辅助经口侧磨牙入路、低温血浆消融和术中下颌神经监测切除良性颞下窝肿瘤的方案。这种微创技术优先考虑解剖学保留、功能恢复和避免外部疤痕，证明了直径 4 厘米≤界分明确的病变的可行性。

我们开发了一种经口内镜方法，利用血浆消融精准切除和控制出血，实现无疤痕切除同时保护神经和血管。我们将实时手术导航整合进经口内镜技术，这使得肿瘤边界绘制更精确，囊外清扫更为精准，提升了切除的安全性和完整性。我们采用先进技术，包括高分辨率内窥镜、低温血浆消融以实现精确的清扫和术中神经监测，以最大化手术的安全性和准确性。

主要挑战包括如何在脆弱的神经血管结构中切除肿瘤，以及克服陡峭的学习曲线，掌握这一精准的内镜技术。首先规划右侧后臼齿区域的手术通路切口，确保避免颲管和神经血管束，并用亚甲蓝标记该部位。在右颊黏膜非功能区切开一个5厘米的纵切口，位于翼下颌韧带前方。

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