Minimally invasive endoscope-assisted trans-oral excision of huge parapharyngeal space tumors

Li, Shang-Yi; Hsu, Ching-Hui; Chen, Mu‐Kuan

doi:10.1016/j.anl.2014.10.010

Cited by 16 publications

(14 citation statements)

References 15 publications

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“…To the best of our knowledge, the first relevant report describing the use of endoscopy to excise PPS tumors by an EATA is the 2014 report by Chen et al. 23 In total, 95 PPS tumors excised using an EATA have been described in the English-language literature (including our present series) 2,3,6,23–29 (Table 2). The patients comprised 54 males and 38 females (n = 92) with 81 tumors and 10 nontumoral masses (4 cysts, 2 Castleman masses, 3 fibrotic tissues, and 1 marginal-zone follicular hyperplastic mass).…”

Section: Discussionmentioning

confidence: 76%

“…Five operations were converted to open transcervical approaches. 3,28 The complication rate was 27.4% (26/95): complications included pharyngeal dehiscence (n = 2), 2 tumor fragmentation (n = 11), 2,6,25,26 laryngeal palsy (n = 5), 27,28 Horner’s syndrome (n = 3), 27 lip/tongue numbness (n = 1), 27 a mouth-opening limitation (n = 1), 27 a temporary mouth corner deviation (n = 1), 27 effusion (n = 1), 28 soft palate necrosis (n = 1), 28 and secretory otitis media (n = 1). 28 One case of pharyngeal dehiscence resolved completely after conservative treatment, and the other required further surgery.…”

Section: Discussionmentioning

confidence: 99%

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Excision of tumors in the parapharyngeal space using an endoscopically assisted transoral approach: a case series and literature review

Chen¹,

Chen²,

Yu³

et al. 2018

J Int Med Res

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Objective Magnetic resonance imaging (MRI) provides important information regarding tumors in the parapharyngeal space (PPS), revealing their origin, whether they are benign or malignant, and their relationships with surrounding structures. Methods Twelve tumors in the PPS were completely excised using an endoscopically assisted transoral approach (EATA). The MRI features were analyzed. Results Ten pleomorphic adenomas confirmed on postoperative pathological examination had the parotid pedicle sign. A fat space between the tumor and parotid gland may distinguish such a tumor from a tumor arising from a minor salivary gland in the prestyloid space and a tumor arising from the deep lobe of the parotid gland. Both the jugular vein and carotid artery were displaced posteriorly in all 10 cases of pleomorphic adenomas. The principal features of the two schwannomas confirmed on postoperative pathological examination were separation of the internal carotid artery and internal jugular vein and anteromedial displacement of the internal carotid artery, suggesting that the tumors originated in the poststyloid space. In this review, 95 tumors were excised by the EATA in the English-language literature. Conclusions MRI renders differential diagnosis possible. PPS tumors may be completely excised via an EATA guided by tumor features evident on preoperative MRI.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Excision of tumors in the parapharyngeal space using an endoscopically assisted transoral approach: a case series and literature review

Chen¹,

Chen²,

Yu³

et al. 2018

J Int Med Res

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“…The trans-oral approach is safe, convenient, and economical for selected PPS tumors: those bulging significantly toward to the oropharynx, with no trismus or previous radiotherapy-related tissue fibrosis, and no sign of vital structure involvement. [ 19 ] The whole surgery is performed in a deep and narrow space that requires surgeons to provide accurate hemostasis and meticulous protection of critical anatomical structures. However, a cervical incision should be considered in case it is required as an adjunctive maneuver.…”

Section: Discussionmentioning

confidence: 99%

“…An angled endoscope enables access to a deeper area and facilitates complete resection. [ 19 ] Currently, the trans-oral robotic surgery (TORS) used in the resection of PPS tumors is emerging as a new technique, allowing the use of magnified 3-dimensional visualization and wristed instruments that are convenient for working in narrow corridors. Several institutions have reported their experience with TORS in the removal of PPS tumors, with excellent feasibility and safety.…”

Section: Discussionmentioning

confidence: 99%

Basal cell adenoma in the parapharyngeal space resected via trans-oral approach aided by endoscopy

Bao

Zhou

et al. 2018

Medicine

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Rationale:Basal cell adenoma (BCA) is a rare benign salivary gland tumor. It is difficult to be completely resected when arising in parapharyngeal space. A contemporary trend is to develop minimally invasive approaches on the premises of safety and complete resection.Patient concerns:Three patients were referred to our ENT Outpatient Department with the chief complaint of an uncomfortable throat. CT or MRI revealed a unilateral mass in the parapharyngeal space, round or oval in shape, with well-defined borders.Diagnoses:CT and MRI provided useful information for the preoperative evaluation. The appearance of large-scale cystic components may be an important clue for the diagnosis of BCA. PET/CT images were also available in one case. The final diagnoses were all basal cell adenomas (tubular type) in parapharyngeal space according to the regular histopathological examination after surgery.Interventions:All three cases were completely resected by a trans-oral approach. The average operative time and estimated blood loss were 86 (range, 61–106) min and 116.7 (range, 50–200) mL, respectively. Endoscopy was used in the largest case to further assess the residual cavity after the complete resection and hemostasis.Outcomes:Postoperative recovery courses were quick and uneventful, with no neurovascular complication. Patients were discharged on the 3rd–5th day after surgery on an oral diet. One patient reported symptoms of velopharyngeal incompetence, manifested as mild slurred speech and nighttime salivation, for up to 3 months, which recovered spontaneously thereafter. There was no evidence of recurrence in the follow-up period.Lessons:In our experience, the trans-oral approach appeared to be effective, safe, and less invasive for extirpation of selected basal cell adenomas in the parapharyngeal space. An assistance of endoscopy facilitates the surgery.

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“…5,6 Recently, a few small case series have been published and demonstrate that endoscopy and a robot can be used transorally to resect large benign parapharyngeal space tumors. [7][8][9][10] In this report, we review the cases of 9 patients who underwent treatment for PPS masses via an endoscopic transoral approach. We discuss the potential advantages and disadvantages of this approach compared with the external surgical approaches, the traditional transoral approach, and transoral robotic surgery.…”

Section: Introductionmentioning

confidence: 99%

Early Experience in Endoscopic Transoral Resection for Parapharyngeal Space Tumors

et al. 2018

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The purpose of this study was to investigate the feasibility, safety, and efficacy of the resection of parapharyngeal space (PPS) tumors via an endoscopic transoral approach. We reviewed 9 patients who were diagnosed with PPS tumors and who were treated with an endoscopic transoral approach. PPS tumors ranging from 2.5 to 6 cm were removed completely with no complications and excellent recovery (mean inpatient hospital stay: 6.89 days). Pathology was pleomorphic adenoma (n = 7), schwannoma (n = 1) and malignant pleomorphic adenoma (n = 1). For the malignant lesion, the patient underwent postoperative radiotherapy (70 Gy). There was no radiographic evidence of recurrences, with mean follow-up of 11.22 months (range: 3 to 20). We conclude that resection of PPS tumors via an endoscopic transoral approach appears to be feasible, safe, and effective. Potential advantages of this approach include an excellent surgical view, rapid surgical access, less tissue injury, avoidance of external scar, fewer postoperative complications, and less morbidity.

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Minimally invasive endoscope-assisted trans-oral excision of huge parapharyngeal space tumors

Cited by 16 publications

References 15 publications

Excision of tumors in the parapharyngeal space using an endoscopically assisted transoral approach: a case series and literature review

Excision of tumors in the parapharyngeal space using an endoscopically assisted transoral approach: a case series and literature review

Basal cell adenoma in the parapharyngeal space resected via trans-oral approach aided by endoscopy

Early Experience in Endoscopic Transoral Resection for Parapharyngeal Space Tumors

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