Classification system for lateral pharyngotomy: systematic study of anatomic exposure in a human cadaver model

Area of Science:

• Anatomy
• Surgical Oncology
• Head and Neck Surgery

Background:

• Lateral pharyngotomy (LP) is a critical surgical technique for accessing tumors in the pharynx and supraglottic larynx.
• Existing classifications for LP approaches are limited, hindering precise surgical planning.

Purpose of the Study:

• To introduce a novel classification system for lateral pharyngotomy (LP) based on surgical exposure.
• To delineate the visible anatomical structures associated with each LP classification type.

Main Methods:

• Dissection of five human cadavers simulating lateral pharyngotomy (LP).
• Progressive division of adjacent neck structures to assess incremental exposure.
• Recording of visualized anatomical sites, including the epiglottis, tongue base, and larynx.

Main Results:

• Traditional (Type I) LP visualized the epiglottis and ipsilateral tongue base.
• Types II, III, and IV LP progressively increased exposure to more distant pharyngeal and laryngeal tumor sites.
• Consistent exposure patterns were observed across all cadaver specimens.

Conclusions:

• A systematic classification of lateral pharyngotomy (LP) based on anatomical divisions is proposed.
• This system correlates specific structural divisions with enhanced visualization of cephalic and caudal tumor locations.
• The study provides a framework for understanding and planning surgical access in head and neck oncology.