On computed tomography (CT) with intravenous contrast, a large, soft-tissue nasopharyngeal mass with extension into and erosion of the sphenoid sinus walls, pterygoid plates
, and sella turcica and protrusion into the middle cranial fossa was found (figures 1 and 2).
Axial and coronal computed tomography (CT) images of the maxillofacial bones (Figures 2 and 3) demonstrate extensive cortical destruction, osteosclerosis, cortical thickening, and fragmentation of the right maxilla, which extends into the frontal process of the zygomatic bone and pterygoid plates
A wide local excision involving the soft palate, right posterior maxilla and right pterygoid plates
and right temporoparietal galeal flap reconstruction was performed with 500 ml estimated blood loss.
The tumor also extended posteriorly along the base of the cranial vault, destroying the pterygoid plates
inferiorly and the clinoid process superiorly.
12) Stage Description IA Involvement limited to the nose and/or naso- pharynx IB Extension into one or more sinuses IIA Minimal extension into the pterygopalatine fossa IIB Occupation of the entire pterygopalatine fossa with or without erosion of the orbital apex IIC Involvement of the infratemporal fossa with or without extension to the cheek or posterior to the pterygoid plates
IIIA Erosion of the skull base (the middle cranial fossa/base of the pterygoids); minimal intra- cranial extension IIIB Erosion of the skull base; extensive intra- cranial extension with or without cavernous sinus invasion Table 1.
It had eroded the base of the pterygoid plates
and infiltrated the lateral pterygoid muscle.
The maxilla is separated from the pterygoid plates
behind and can then be downfractured.