Resection of upper aerodigestive tract tumors involving the middle cranial fossa

Benign and malignant neoplasms of the upper aerodigestive tract that invade the middle cranial fossa are frequently considered unresectable due to the proximity of the cavernous sinus and internal artery, and to the inaccessibility of this region via conventional surgical approaches. We report our experience using a combined, lateral intracranial and infratemporal fossa procedure for the management of these tumors in four patients. Successful removal of neoplasm associated with minimal morbidity was accomplished in 3 patients, 2 with angiofibromas and 1 with an adenoid cystic carcinoma. The postoperative course of the fourth patient was complicated by meningitis which resulted in the patient's death five months following resection of an adenocarcinoma.