Transoral robotic parapharyngeal space dissection.

Area of Science:

• Otolaryngology
• Surgical Oncology
• Robotic Surgery

Background:

• Transoral robotic surgery (TORS) is a minimally invasive technique for head and neck tumors.
• The parapharyngeal space (PPS) presents surgical challenges due to its complex neurovascular anatomy.
• Oropharyngeal tumors may extend into the PPS, requiring precise surgical navigation.

Purpose of the Study:

• To provide a detailed endoscopic anatomical understanding of the lower parapharyngeal space.
• To demonstrate the utility of transoral robotic surgery for accessing and dissecting the PPS.
• To potentially reduce morbidity associated with resecting tumors in this challenging region.

Main Methods:

• Step-by-step cadaveric dissection of the lower parapharyngeal space.
• Utilized a transoral robotic approach for the dissection.
• Video-documentation of the surgical anatomy and dissection process.

Main Results:

• Detailed visualization of the lower parapharyngeal space endoscopic anatomy was achieved.
• The transoral robotic approach allowed for precise dissection around critical neurovascular structures.
• The feasibility of TORS for navigating the dense PPS was demonstrated.

Conclusions:

• Enhanced understanding of parapharyngeal space anatomy via TORS is crucial for safe tumor resection.
• Robotic-assisted transoral dissection facilitates navigation of the complex PPS.
• This approach may improve outcomes for patients with advanced oropharyngeal tumors.