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Background/Objectives: Although the endoscopic extended latissimus dorsi (eeLD) flap avoids dorsal scarring, a lateral thoracic incision is still required. We developed an axillary-approach endoscopic extended latissimus dorsi (Ax-eeLD) flap enabling harvest through a single 40-mm axillary incision and two 5-mm ports. This study evaluated its safety and feasibility and compared outcomes with conventional eeLD. Methods: Patients who underwent Ax-eeLD flap (study group) were retrospectively analyzed and compared with the patients who underwent conventional eeLD flap (control group, n = 15). The flap was elevated endoscopically via a single 40-mm axillary incision and two 5-mm ports, harvesting the entire latissimus dorsi muscle with its surrounding adipose tissue. Outcomes included incision length, operative time, complications, secondary fat grafting, and BREAST-Q scores. Results: Fifteen patients (post-mastectomy, n = 13; congenital hypoplasia, n = 2) underwent Ax-eeLD flap. All procedures used only the planned incisions without intraoperative complications. The study group had significantly shorter incisions than the control group (39 ± 1 mm vs. 89 ± 9 mm, p < 0.01). Operative times were similar between the groups. Eight patients developed seromas, all of which were resolved by outpatient aspiration. The frequency of postoperative cases requiring fat grafting did not differ significantly between the study and control groups (4 vs. 8; p = 0.26). BREAST-Q scores improved postoperatively and were similar between groups. Conclusions: Ax-eeLD flap enables minimally invasive harvest of the latissimus dorsi without lateral thoracic scarring. This retrospective case series supports technical feasibility and safety; further prospective studies with objective volume assessment are required. Full article

Background: Infratemporal fossa (ITF) tumors represent various pathologies and are seldom described in the literature, reflecting their rarity. Here we review the literature on tumors invading ITF and describe patient characteristics, treatment strategies, and clinical outcomes. Methods: Relevant articles were retrieved from PubMed, Scopus, and Cochrane. A systematic review and meta-analysis were conducted on the clinical presentation, treatment protocols, and clinical outcomes. Result: A total of 27 articles containing 106 patients with ITF tumors (median tumor size: 24.3 cm³ [interquartile range, 15.2–42 cm³]) were included (median age: 46 years [interquartile range, 32–55 years]; 59.4% were males]). Of the confirmed tumor pathology data, schwannomas (n = 24; 26.1%) and meningiomas (n = 13; 14.1%) were the most common tumors. Facial hypoesthesia (n = 22; 18.5%), auricular/preauricular pain (n = 20; 16.8%), and headaches (n = 11; 9.2%) were the most common presenting symptoms. Of patients who had surgical resection (n = 97; 95.1%), 70 (73.7%) had transcranial surgery (TCS) and 25 (26.3%) had endoscopic endonasal surgery (EES). Among available details on the extent of resection (n = 84), gross-total resection (GTR) was achieved in 62 (73.8%), and 5 (6.0%) had biopsy only. Thirty-five (33.0%) patients had postoperative complications. Among cases with available data on reconstruction techniques (n = 8), four (50%) had adipofascial antero-lateral thigh flap, three (37.5%) had latissimus dorsi free flap, and one (12.5%) had antero-lateral thigh flap. Fourteen (13.2%) patients had adjuvant chemotherapy, and sixteen (15.1%) had adjuvant radiotherapy. During a median follow-up time of 28 months (IQR, 12.25–45.75 months), 15 (14.2%) patients had recurrences, and 18 (17.0%) patients died. The median overall survival (OS) time was 36 months (95% confidence interval: 29–41 months), and the 5-year progression-free survival (PFS) rate was 61%. Conclusion: Various tumor types with different biological characteristics invade the ITF. The present study describes patient demographics, clinical presentation, management, and outcomes. Depending on the tumor type and patient condition, patient-tailored management is recommended to optimize treatment outcomes. Full article