Vascular Control-Focused Surgical Strategy for Pterygopalatine and Infratemporal Fossa Tumors Using Multimodal Image Fusion Reconstruction.

OBJECTIVE

To classify tumor-internal maxillary artery (IMA) spatial relationships in pterygopalatine and infratemporal fossa (PPF/ITF) tumors, develop a 3D fusion-guided vascular control-focused surgical strategy, and evaluate its clinical impact.

METHODS

Seventeen patients were prospectively enrolled in the 3D fusion-guided vascular control-focused strategy (VCFS) group, while 41 patients were retrospectively enrolled in the conventional strategy group. Multimodal imaging data were used to generate patient-specific 3D models to classify tumor-IMA spatial relationships and guide surgical planning under the VCFS framework. Surgical outcomes were compared using stabilized inverse probability of treatment weighting (sIPTW).

RESULTS

Compared to the conventional strategy, the VCFS significantly reduced blood loss (200 vs. 800 mL; p = 0.037), decreased complications (33.8% vs. 74.3%; p = 0.017), improved complete resection rates (94.7% vs. 32.7%; p < 0.001), but prolonged operative time (4.5 h vs. 3.0 h; p = 0.005). Hospital stay was similar.

CONCLUSIONS

Multimodal imaging-based classification of tumor-IMA relationships and application of the VCFS were associated with improved short-term surgical outcomes in patients with PPF/ITF tumors.