In this study, all patients had lateral extension through destruction of pterygoid plates
Imaging revealed diffuse sinus opacification and a Le Fort type I complexfracture involving the maxilla, pterygoid plates
, clivus, and right nasal bridge.
The pterygoid plates
arise laterally and medially from the inferior surface of the side of the body and from the root of the greater wing.
Tumor causing bone erosion or destruction including extension into the hard palate and/or middle nasal meatus, except extension to posterior wall of maxillary sinus and pterygoid plates
is a T2 stage tumor.
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.
The pneumatization of the sphenoid sinus can vary from total non-pneumatization to hyperpneumatization including clinoid processes, sphenoid wings and pterygoid plates
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).
CT scan showed Mass involving bilateral maxillary sinus, eroding the pterygoid plates
, destruction of sphenoid sinus, involving the orbital cavity and pushing of right eye outwards [Fig.
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.
Sphenoid Sinus Pneumatization: The pneumatization of the sphenoid sinus can vary from total nonpneumatization to hyperpneumatization including clinoid processes, sphenoid wings and pterygoid plates