To prevent damaging CN IX than CN X or XI.Figure 3. Fascial tissue attached around the vaginal process. (A) Inferolateral view. The fascial layers attached for the vag inal Fenvalerate Technical Information procedure are shown in the appropriate cadaveric head. Tensor vascular styloid fascia forms a a part of the carotid sheath. (B) Inferior view. The carotid sheath was composed on the stylopharyngeal fascia, tensor vascular styloid fascia, pharyngo basilar fascia, fasciae on the longus capitis, and fascia anterior for the rectus capitis 4-Epianhydrotetracycline (hydrochloride) manufacturer lateralis. (C) Inferior view just after removal of the carotid sheath. (D) Anteroinferior view. The glossopharyngeal nerve coursing medially towards the root on the styloid approach and vaginal course of action. A., artery; C.N., cranial nerve; Cap., capitis; Dig., digastric; EAC, external auditory canal; Fibrocart., fibrocartilaginous; ICA, internal carotid artery; IJV, internal jugular vein; Lat., lateral; Late., lateralis; Lev., le vator; Extended., longus; N., nerve; Palat., palatini; Pharyngobas., pharyngobasilar; Proc., method; Pteryg., pterygoid; Rec., rectus; Sphen., sphenoid; Stylophar., stylopharyngeal; Styl., styloid; Tens., tensor; TVS, tensorvascularstyloid fascia; Vert., vertebral; Vag., vaginal.Cancers 2021, 13,18 of3.two. Variation of Bone Cutting for en Bloc Temporal Bone Resection The range of osteotomy differs among procedures. In cLTBR, osteotomy was lim ited as shown in Figure 4A. Having said that, in the event the tumor extended anteriorly, inferiorly, superi orly, and posteriorly in the EAC, it was impossible to eliminate the tumor with a unfavorable margin making use of cLTBR. We applied eLTBR if the tumor extended inferiorly and was close for the jugular foramen and the styloid approach, which was resected en bloc together with the EAC; the opening of your jugular foramen was frequently needed to complete the tumor resection with a damaging margin (Figure 4B). In the event the tumor extended in to the middle ear, STBR was needed. If the invasion from the tumor into mastoid cavity was restricted, mSTBR, (Figure 4C) combined with posteriorly limited mastoidectomy and temporal craniotomy, was suf ficient to complete the en bloc resection. Even so, in the event the tumor extended to the mastoid cavity and middle ear, we required to perform cSTBR, like retromastoidparacondy lar approaches and huge temporooccipital craniotomy (Figure 4D). In the point of view of surgical anatomy, temporal bone cutting could be divided into quite a few patterns (Figures 5 and 6) Whether the petrous carotid might be exposed through the glenoid fossa (transgle noid fossa procedure: TGP) could affect the difficulty on the exposure and translocation of the petrous carotid (Figure five).Cancers 2021, 13,19 ofFigure four. Threedimensional (3D) bone reconstruction right after temporal bone resection. (A) Traditional lateral temporal bone resection (representative case of cT2). (B) Lateral temporal bone resection with anterior and posterior extension (case eight); (C) Modified subtotal temporal bone resection (case 13). (D) Standard subtotal temporal bone resection en bloc with TMJ (case 15). 3D, threedimensional; Car or truck., carotid; Jug., jugular; Proc., process; Styl., styloid; TMJ, temporomandib ular joint.Cancers 2021, 13,20 ofFigure 5. Variation of temporal bone resection. LTBR, lateral temporal bone resection; STBR, subtotal temporal bone re section; TMJ, temporomandibular joint.three.three. Case Profile The profiles with the 21 patients included inside the study are summarized in Table 1. Our dataset incorporated six males and 15 females (me.