Transoral robotic surgery for the parapharyngeal space: expanding the transoral corridor
To analyze the feasibility, surgical outcomes and possible risks and complications encountered during transoral robotic surgery (TORS) for approaching parapharyngeal space (PPS) tumours, a retrospective cohort study was conducted. Out of 108 TORS procedures performed, 5 PPS tumours were identified from May 2011- November 2017. This study included 2 retrostyloid (benign nerve sheath tumour) and 3 prestyloid tumours (pleomorphic adenoma), of which one patient had previously undergone a transcervical approach for deep lobe of parotid pleomorphic adenoma. Average tumour dimensions were 4.56 × 4.5 × 3.64 cm, with largest antero-posterior, medial—lateral and craniocaudal dimensions being, 5.1 cm, 7.1 cm and 6.5 cm, respectively. Adverse peri-operative events encountered were tumour fragmentation (n = 1), Secondary hemorrhage (n = 1) and Horner’s syndrome (n = 1). Oral feeds could be initiated after 7.6 days. No recurrences were noted during a mean follow up of 21.6 months. Therefore, in properly selected cases, excellent results in terms of extracapsular resection and low morbidity can be obtained with TORS without resorting to mandibulotomy or transcervical incision.
KeywordsTORS Parapharyngeal space Schwannoma Pleomorphic adenoma
Compliance with ethical standards
Conflict of interest
Authors Smriti Panda, Kapil Sikka, Alok Thakar, Suresh C Sharma and Padmavathi Krishnamurthy declare that they have no conflict of interest. Integrity of research and reporting: The manuscript has not been submitted to more than one journal for simultaneous consideration. The manuscript has not been published previously (partly or in full). A single study is not split up into several parts to increase the quantity of submissions and submitted to various journals or to one journal over time (e.g., “salami-publishing”). No data have been fabricated or manipulated (including images) to support conclusions. No data, text, or theories by others are presented as if they were the author’s own (“plagiarism”). Consent to submit has been received explicitly from all co-authors, as well as from the responsible authorities—tacitly or explicitly—at the institute/organization where the work has been carried out, before the work is submitted. Authors whose names appear on the submission have contributed sufficiently to the scientific work, and therefore, share collective responsibility and accountability for the results. Upon request authors are prepared to send relevant documentation or data to verify the validity of the results. This could be in the form of raw data, samples, records, etc. All procedures followed were in accordance with the ethical standards of the Institutional Ethical Committee and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
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