Endoscopic endonasal transpterygoid nasopharyngectomy

Al-Sheibani, Salma; Zanation, Adam M.; Carrau, Ricardo L.; Prevedello, Daniel M.; Prokopakis, Emmanuel P.; McLaughlin, Nancy; Snyderman, Carl H.; Kassam, Amin

doi:10.1002/lary.22165

Cited by 72 publications

(106 citation statements)

References 36 publications

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“…however, major morbidity has been noted. Al-Sheibani et al [12] reported two cases that suffered an ICA blowout. One related to radionecrosis of the cervical soft tissues and the other to osteoradionecrosis of the clivus occurred 3 and 56 months after treatment respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, an extended endoscopic transpterygoid nasopharyngectomy is advantageous to control the lateral extension of tumor. Al-Sheibani et al [12] reported the endoscopic transpterygoid nasopharyngectomy 9/20) and a local control of 65% (13/20). These outcomes have been reproduced by Castelnuovo et al [30] , who recently reported their experience with endoscopic nasopharyngeal resection, similarly including patients with advanced stage.…”

Section: Discussionmentioning

confidence: 99%

“…These outcomes have been reproduced by Castelnuovo et al [30] , who recently reported their experience with endoscopic nasopharyngeal resection, similarly including patients with advanced stage. Their study included 36 consecutive patients with primary (9 patients) and locally recurrent (27 patients) Limitations of endoscopic transpterygoid nasopharyngectomy include the difficulty to resect tumor, encasing the parapharyngeal ICA or extending posterior to the ICA (parapharyngeal or petrous segments) [12] . These situations are best managed combining the endoscopic approaches with robotic and/or open approaches such as the preauricular or postauricular subtemporal approaches [27] .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, surgery plays a significant role in the treatment of radioresistant malignancies, such as those of glandular and mesenchymal origin [10,11] . Primary resection of these radio-resistant tumors seems advantageous [12] .…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Nasopharyngeal Malignancies: Role of Endoscopic Endonasal Approaches

Kasemsiri

Prevedello

Otto

et al. 2014

J Nasopharyng Carcinoma

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Abstract:The development of endoscopic techniques has progressed onward with the recent enrichment of anatomical knowledge and experience, as well as the development of advanced technologies. Expansion of the clinical indications for endoscopic endonasal approaches has produced a paradigm shift in the surgical management of nasopharyngeal malignancies similar to that of other areas of the ventral skull base.Endoscopic endonasal nasopharyngectomy is a feasible minimal access technique indicated for the resection of select recurrent and radioresistant nasopharyngeal malignancies. It bestows the advantages of lack of external incisions or scars, decreased trauma to adjacent soft tissues and bone, reduced risk of neurological damage, and superior postoperative quality of life.A comprehensive review of the available literature shows that endoscopic surgery end-results are better than those yielded by re-irradiation or surgery via conventional open approaches. We acknowledge, however, that these results may be influenced by a bias in patient selection. Nonetheless, they suggest that, in properly selected cases, an endoscopic endonasal nasopharyngectomy affords low morbidity rates without compromising oncologic outcomes.Therefore, endoscopic endonasal approaches play a strong role in the treatment of nasopharyngeal malignancies.Nonetheless, one should be fully aware of the indications and limitations of using endoscopic endonasal approach to achieve optimal outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Treatment of Nasopharyngeal Malignancies: Role of Endoscopic Endonasal Approaches

Kasemsiri

Prevedello

Otto

et al. 2014

J Nasopharyng Carcinoma

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“…Neoplastic lesions of this area have been successfully resected with favorable outcomes and adherence to oncological principles. 1,7,8,32 However, the pure endonasal route can be inadequate for surgical management of pathology extending beyond the anatomical boundaries, such as for extension below the level of the soft palate in the oropharynx (Table 1). Given these limitations, several institutions initially published studies on their clinical and laboratory experience of combining both the EEA and nonrobotic transoral approach for a variety of pathological processes.…”

mentioning

confidence: 99%

The combined endonasal and transoral approach for the management of skull base and nasopharyngeal pathology: a case series

Sreenath

Rawal

Zanation

2014

FOC

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The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation and technology, the expanded endonasal approach (EEA) has introduced a new array of surgical options in the management of pathology involving these anatomically complex areas. Similarly, the transoral robotic surgical (TORS) approach was introduced as a minimally invasive surgical option to approach tongue base, nasopharyngeal, parapharyngeal, and laryngeal lesions. Although both the EEA and the TORS approach have been extensively described as viable surgical options in managing nasopharyngeal and centrally located head and neck pathology, both endonasal and transoral techniques have inherent limitations. Given these limitations, several institutions have published feasibility studies with the combined EEA and TORS approaches for a variety of skull base and nasopharyngeal pathologies. In this article, the authors present their clinical experience with the combined endonasal and transoral approach through a case series presentation, and discuss advantages and limitations of this approach for surgical management of the middle and posterior skull base and nasopharynx. In addition, a presentation is included of a unique, simultaneous endonasal and transoral dissection of the nasopharynx through an innovative intraoperative setup.

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