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Transoral robotic assisted resection of the parapharyngeal space
1Director - Robotic Head & Neck Surgery Program, Department of Head and Neck Surgery, David Geffen School of Medicine at University of California - Los Angeles, Los Angeles, California and Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at University of California - Los Angeles, Los Angeles, California.
Background:
Preliminary case series have reported clinical feasibility and safety of a transoral minimally invasive technique to approach parapharyngeal space masses. With the assistance of the surgical robotic system, tumors within the parapharyngeal space can now be excised safely without neck incisions. A detailed technical description is included.
Methods:
After developing compressive symptoms from a parapharyngeal space lipomatous tumor, the patient was referred by his primary otolaryngologist because of poor open surgical access to the nasopharyngeal component of the tumor.
Results:
Transoral robotic assisted resection of a 54- × 46-mm parapharyngeal space mass was performed, utilizing 97 minutes of robotic surgical time. Pictorial demonstration of the robotic resection is provided.
Conclusion:
Parapharyngeal space tumors have traditionally been approached via transcervical skin incisions, typically including blunt dissection from tactile feedback. The transoral robotic approach offers magnified 3D visualization of the parapharyngeal space that allows for complete and safe resection.
