Considerations on multiportal compartmental approach extended to the temporal fossa

Enrico Fazio; Luca Gazzini; Giulia Gobbo; Monir Abousiam; Giovanni Giorgetti; Aurel Nebiaj; Giuseppe Nucera; Alberto Schreiber; Luca Calabrese

doi:10.1007/s00405-025-09674-5

Considerations on multiportal compartmental approach extended to the temporal fossa

Enrico Fazio
, Luca Gazzini
, Giulia Gobbo
, Monir Abousiam
, Giovanni Giorgetti
, Aurel Nebiaj
, Giuseppe Nucera
, Alberto Schreiber
, Luca Calabrese

Bolzano Hospital

Provincial Hospital of Bolzano (SABES-ASDAA)
University of Verona and University and Hospital Trust (AOUI) of Verona
Hospital of Manerbio-Desenzano

Research output: Contribution to journal › Letter to the editor › peer-review

Abstract

PURPOSE: To illustrate the applicability of compartmental surgery (CS) principles in the radical management of advanced oral cavity squamous cell carcinoma (OSCC) involving the high infratemporal fossa (ITF), in cases where neoadjuvant therapy is not feasible.

METHODS: We report a case of recurrent OSCC of the retromolar trigone with extensive involvement of the masticatory space, including the medial and lateral pterygoid, masseter, and temporalis muscles. A multiportal surgical approach was employed, integrating a transnasal endoscopic route with extended transoral and transcervical corridors. Surgical steps followed the CS concept, including en-bloc resection of tumour spread pathways and musculature insertions.

RESULTS: Radical resection including the involved masticatory musculature and temporalis muscle insertions was achieved. The final histopathology confirmed advanced-stage disease (rpT4b N3b R0 L1 V0 pn1 G2), with complete macroscopic and microscopic tumour removal.

CONCLUSION: This case supports the feasibility and oncologic efficacy of a CS-based multiportal approach in selected advanced OSCC involving the ITF. Further studies are needed to validate its role and define standardized protocols.

Original language	English
Number of pages	3
Journal	EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
Early online date	Oct 2025
DOIs	https://doi.org/10.1007/s00405-025-09674-5
Publication status	Published - 1 Oct 2025

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@article{7eeb5eaba5044ba683e3a13759483e60,

title = "Considerations on multiportal compartmental approach extended to the temporal fossa",

abstract = "PURPOSE: To illustrate the applicability of compartmental surgery (CS) principles in the radical management of advanced oral cavity squamous cell carcinoma (OSCC) involving the high infratemporal fossa (ITF), in cases where neoadjuvant therapy is not feasible.METHODS: We report a case of recurrent OSCC of the retromolar trigone with extensive involvement of the masticatory space, including the medial and lateral pterygoid, masseter, and temporalis muscles. A multiportal surgical approach was employed, integrating a transnasal endoscopic route with extended transoral and transcervical corridors. Surgical steps followed the CS concept, including en-bloc resection of tumour spread pathways and musculature insertions.RESULTS: Radical resection including the involved masticatory musculature and temporalis muscle insertions was achieved. The final histopathology confirmed advanced-stage disease (rpT4b N3b R0 L1 V0 pn1 G2), with complete macroscopic and microscopic tumour removal.CONCLUSION: This case supports the feasibility and oncologic efficacy of a CS-based multiportal approach in selected advanced OSCC involving the ITF. Further studies are needed to validate its role and define standardized protocols.",

author = "Enrico Fazio and Luca Gazzini and Giulia Gobbo and Monir Abousiam and Giovanni Giorgetti and Aurel Nebiaj and Giuseppe Nucera and Alberto Schreiber and Luca Calabrese",

note = "Lehr-KH Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medizinischen Privatuniversit{\"a}t (PMU), Bozen, Italy",

year = "2025",

month = oct,

day = "1",

doi = "10.1007/s00405-025-09674-5",

language = "English",

journal = "EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY",

issn = "0937-4477",

publisher = "Springer Nature",

}

TY - JOUR

T1 - Considerations on multiportal compartmental approach extended to the temporal fossa

AU - Fazio, Enrico

AU - Gazzini, Luca

AU - Gobbo, Giulia

AU - Abousiam, Monir

AU - Giorgetti, Giovanni

AU - Nebiaj, Aurel

AU - Nucera, Giuseppe

AU - Schreiber, Alberto

AU - Calabrese, Luca

N1 - Lehr-KH Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medizinischen Privatuniversität (PMU), Bozen, Italy

PY - 2025/10/1

Y1 - 2025/10/1

N2 - PURPOSE: To illustrate the applicability of compartmental surgery (CS) principles in the radical management of advanced oral cavity squamous cell carcinoma (OSCC) involving the high infratemporal fossa (ITF), in cases where neoadjuvant therapy is not feasible.METHODS: We report a case of recurrent OSCC of the retromolar trigone with extensive involvement of the masticatory space, including the medial and lateral pterygoid, masseter, and temporalis muscles. A multiportal surgical approach was employed, integrating a transnasal endoscopic route with extended transoral and transcervical corridors. Surgical steps followed the CS concept, including en-bloc resection of tumour spread pathways and musculature insertions.RESULTS: Radical resection including the involved masticatory musculature and temporalis muscle insertions was achieved. The final histopathology confirmed advanced-stage disease (rpT4b N3b R0 L1 V0 pn1 G2), with complete macroscopic and microscopic tumour removal.CONCLUSION: This case supports the feasibility and oncologic efficacy of a CS-based multiportal approach in selected advanced OSCC involving the ITF. Further studies are needed to validate its role and define standardized protocols.

AB - PURPOSE: To illustrate the applicability of compartmental surgery (CS) principles in the radical management of advanced oral cavity squamous cell carcinoma (OSCC) involving the high infratemporal fossa (ITF), in cases where neoadjuvant therapy is not feasible.METHODS: We report a case of recurrent OSCC of the retromolar trigone with extensive involvement of the masticatory space, including the medial and lateral pterygoid, masseter, and temporalis muscles. A multiportal surgical approach was employed, integrating a transnasal endoscopic route with extended transoral and transcervical corridors. Surgical steps followed the CS concept, including en-bloc resection of tumour spread pathways and musculature insertions.RESULTS: Radical resection including the involved masticatory musculature and temporalis muscle insertions was achieved. The final histopathology confirmed advanced-stage disease (rpT4b N3b R0 L1 V0 pn1 G2), with complete macroscopic and microscopic tumour removal.CONCLUSION: This case supports the feasibility and oncologic efficacy of a CS-based multiportal approach in selected advanced OSCC involving the ITF. Further studies are needed to validate its role and define standardized protocols.

U2 - 10.1007/s00405-025-09674-5

DO - 10.1007/s00405-025-09674-5

M3 - Letter to the editor

C2 - 41034639

SN - 0937-4477

JO - EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY

JF - EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY

ER -

Considerations on multiportal compartmental approach extended to the temporal fossa

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