Trans-Oral Robotic Surgery: 14 Cases of Pleomorphic Adenoma of the Parapharyngeal Space

Abstract

Purpose: The aim of this study has been to describe our experience with pleomorphic adenomas of the parapharyngeal space (PPS) treated with trans-oral robotic surgery (TORS). Tumors arising from the PPS comprise less than 0.5% of all head and neck tumors. Salivary gland tumors account for 40% to 50% of PPS lesions with pleomorphic adenomas representing the most common salivary tumors (80%–90%). Parapharyngeal space tumors cause nonspecific symptoms and may be difficult to diagnose. Methods: In our study a preoperative diagnosis was conducted by fine needle aspiration biopsy and magnetic resonance imaging and the results were used to plan the correct surgical approach. Results: In all cases we were able to employ TORS, a minimally invasive procedure that allows us to operate in narrow and anatomically complex spaces that we can only reach thanks to the use of well-articulated hand pieces. Conclusions: This report indicates that TORS is a safe surgical procedure for the excision of benign tumors of the PPS in selected cases.

Transoral robotic surgery approach for relapse in parapharyngeal space of papillary thyroid carcinoma: Case series

“…In this report we present four cases of PTC metastasis to the PPS that were managed with the TORS technique, achieving a safe and feasible resection in these carcinomas. Another case series, published by Salzano et al 7 also found that TORS was a safe surgical procedure to resect benign tumours of the PPS.…”

Transoral robotic surgery for parapharyngeal carcinoma ex‐pleomorphic adenoma: A case report

“…The surgical treatment method for this patient was TORS technique, considering the multiple studies that have reported its advantages in the treatment of benign and malignant tumors of the oropharynx and larynx, 8–14 and its low morbidity rate 9,13 . Its indications for the management of resections of benign tumors like adenoma pleomorphic of the PPS are known 15 . However, its usage continues to be controversial for malignant tumors of this location 11 .…”

“… 9 , 13 Its indications for the management of resections of benign tumors like adenoma pleomorphic of the PPS are known. 15 However, its usage continues to be controversial for malignant tumors of this location. 11 Critics of this approach do not favor its usage, arguing that there is limited exposure, especially for larger tumors increasing the risk for both tumor spillage/implantation and the risk of infection and neurovascular injury even with careful pre‐ operative evaluation.…”