颞下耳前颞下 (SPI) 入路结合髁窝截骨术能够提供最大程度的病灶暴露，在颅底肿瘤的根治性切除术中得到广泛应用。虽然这种方法需要破坏颞下颌关节 (TMJ) 才能进入，但这种操作的效果在神经外科中却很少被认识到。本研究的目的是通过比较涉及 TMJ 和保留 TMJ 颅底入路后的口腔健康生活质量 (OHQOL) 和一般健康生活质量 (GHQOL) 结果来评估髁窝截骨术的发病率。研究人员对 2002 年至 2022 年间在温哥华综合医院的一位资深外科医生接受 SPI 入路（涉及颞下颌关节入路）颅底软骨肉瘤 (CS) 手术的患者的医疗记录进行了分析。在同一研究期间，由同一位外科医生接受保留颞下颌关节前外侧入路治疗三叉神经鞘瘤（TS）的患者作为对照。使用术前和术后期间的 36 项简短健康调查评估 GHQOL。使用颞下颌疾病诊断标准 (DC/TMD) Axis I/II 筛查仪评估术后 OHQOL。2002 年至 2022 年间，19 名 CS 患者中的 13 名和 15 名 TS 患者中的 12 名接受了手术治疗，获得了有关生活质量的数据。在专门评估 OHQOL 时，患者在 DC/TMD 轴 I/II 组件的所有参数中表现出较少的下颌功能障碍。在 TMD 疼痛筛查中，CS 患者出现颞下颌关节紊乱 (TMD) 的可能性低于 TS 患者（25% vs 45%，p = 0.40）。 TS 组的慢性疼痛评分较高，2 级或以上疼痛的患者明显更多（36.4% vs 0%，p = 0.01）。 CS 患者的平均下颌功能限制量表 (JFLS) 评分低于 TS 患者。 CS 和 TS 患者的平均 JLFS 评分（分别为 0.50 和 0.81）均低于慢性 TMD 患者（1.76），但平均 JLFS 评分高于无 TMD 患者（0.16）。作者报告了有关 SPI 影响的新发现髁窝截骨术对颅底肿瘤患者的 OHQOL 和 GHQOL 的影响。颞下颌关节的解剖破坏与显着的临床颞下颌关节功能障碍无关。与 TS 患者相比，CS 患者的 TMJ 相关发病率平均得分更低，且两组的 TMJ 发病率均低于诊断为慢性 TMJ 功能障碍的患者。因此，可以考虑髁窝截骨术，而不用担心显着的额外发病率。

With the capacity to provide maximal lesion exposure, the subtemporal preauricular infratemporal (SPI) approach with condylar fossa osteotomy is highly utilized in radical resection of skull base tumors. While this approach requires disruption of the temporomandibular joint (TMJ) for access, the effects of this maneuver are poorly appreciated in neurosurgery. The aim of this study was to assess the morbidity of condylar fossa osteotomies by comparing oral health quality of life (OHQOL) and general health quality of life (GHQOL) outcomes after TMJ-involving and TMJ-sparing skull base approaches.A retrospective review of the medical records of patients who underwent surgery with the SPI approach (TMJ-involving approach) for skull base chondrosarcoma (CS) by a single senior surgeon at Vancouver General Hospital between 2002 and 2022 was performed. Patients undergoing TMJ-sparing anterolateral approaches for trigeminal schwannoma (TS) during the same study period by the same surgeon were included as controls. GHQOL was evaluated using the 36-item Short Form Health Survey from preoperative and postoperative periods. Postoperative OHQOL was evaluated using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I/II screening instrument.Data regarding quality of life were available for 13 of 19 CS patients and 12 of 15 TS patients surgically managed between 2002 and 2022. CS patients demonstrated less jaw dysfunction in all parameters of the DC/TMD Axis I/II components when specifically assessing OHQOL. CS patients had a lower likelihood of temporomandibular disorder (TMD) presence on the TMD pain screener than TS patients (25% vs 45%, p = 0.40). Chronic pain scores were higher in the TS group, with significantly more patients with grade 2 or higher pain (36.4% vs 0%, p = 0.01). The mean Jaw Functional Limitation Scale (JFLS) scores were lower in CS patients than in TS patients. Both CS and TS patients demonstrated lower mean JLFS scores (0.50 and 0.81, respectively) than patients with chronic TMD (1.76), but higher mean JLFS scores than patients without TMD (0.16).The authors report novel findings regarding the impact of the SPI approach with a condylar fossa osteotomy on OHQOL and GHQOL among skull base tumor patients. Anatomical disruption of the TMJ was not associated with significant clinical TMJ dysfunction. Compared with TS patients, CS patients had even lower mean scores in TMJ-related morbidity, and both groups had lower TMJ morbidity than patients diagnosed with chronic TMJ dysfunction. Condylar fossa osteotomies can therefore be considered without concern of significant additional morbidity.