Triportal approach: endoscopic transorbital, transnasal and robotic transoral excision of parapharyngeal liposarcoma

A parapharyngeal space (PPS) tumor is a rare head and neck tumor. The choice of approach depends on the location, pathology, extent of invasion, and relationship with surrounding neurovascular structures. In this video, a PPS tumor was resected using a triportal approach: endoscopic transorbital, robotic transoral, and endoscopic transnasal surgery. Neurosurgeons, otorhinolaryngologists, and ophthalmologists jointly performed the operation. The pathology was a liposarcoma in the right upper parapharyngeal space, abutting the internal carotid artery. Postoperative endoscopy, MRI, and PET-CT showed no recurrence. The triportal approach is a novel technique in improving the exposure and multiangular dissection of PPS tumors with optimal protection to surrounding neurovascular structures. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24167.