Endoscopic transoral nasopharyngectomy

Soriano, Roberto M.; Rindler, Rima S.; Helman, Samuel N.; Pradilla, Gustavo; Solares, C. Arturo

doi:10.1002/hed.26483

Cited by 5 publications

(5 citation statements)

References 32 publications

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“…14 As for the transoral approach, an incision is made at the medial side of the pterygomandibular ligament. 8 The superior pharyngeal constrictor muscle can therefore be separated to enter the PPS. The ET can be approached upwards.…”

Section: Discussionmentioning

confidence: 99%

“…A transpterygoid approach is necessary for exposure and resection of the ET 14 . As for the transoral approach, an incision is made at the medial side of the pterygomandibular ligament 8 . The superior pharyngeal constrictor muscle can therefore be separated to enter the PPS.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Previous studies have also suggested a transoral transpalatal approach that can avoid dealing with the pterygoid process, and thus, may help with dissection and protect the parapharyngeal internal carotid artery (ICA). 8,9 The main surgery for early staged recurrent NPC is nasopharyngectomy around the ET. The conventional endoscopic endonasal surgery often requires a transpterygoid approach to expose the structure around the ET, which is traumatic and time consuming, and identification of the ICA is indefinite.…”

Section: Introductionmentioning

confidence: 99%

“…Endoscopic salvage surgery for recurrent NPC is widely accepted and recognized 6,7 . Previous studies have also suggested a transoral transpalatal approach that can avoid dealing with the pterygoid process, and thus, may help with dissection and protect the parapharyngeal internal carotid artery (ICA) 8,9 . The main surgery for early staged recurrent NPC is nasopharyngectomy around the ET.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic endonasal combined transoral medial approach to the nasopharynx, parapharyngeal space, and jugular foramen

Mao,

Tang,

et al. 2023

Head & Neck

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Objective: This study aimed to validate the feasibility of an endoscopic endonasal combined transoral medial approach for treating lesions in the nasopharynx, parapharyngeal space (PPS), and jugular foramen.Methods: Anatomical and imaging information of six patients who underwent surgery via this approach were reviewed and analyzed.Results: The feasibility and advantages of the endoscopic endonasal combined transoral medial approach, which uses an inside‐to‐outside medial surgical corridor, were identified. Total resection was achieved in 3 cases with benign tumors. Safe resection margins were obtained in 2 cases with recurrent nasopharyngeal carcinoma (NPC). Pathological biopsy of NPC lesion between the Eustachian tube and arterial sheath was achieved. The internal carotid artery (ICA) was accurately located and protected in all cases and no complications occurred.Conclusion: Lesions in the nasopharynx, PPS, and jugular foramen can be directly assessed via this approach. The ICA can be well identified during the surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic endonasal combined transoral medial approach to the nasopharynx, parapharyngeal space, and jugular foramen

Mao,

Tang,

et al. 2023

Head & Neck

View full text Add to dashboard Cite

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“…Based on previously described methods, the AoE was calculated by the length and width of a region in which targets can be manipulated during a surgical approach. 11,12 Four anatomic landmarks were selected to establish the exposed area. These included the most superomedial, superolateral, inferomedial, and inferolateral aspects of the contralateral medial orbital wall.…”

Section: Area Of Exposurementioning

confidence: 99%

The Role of the Transeptal Window in Endoscopic Endonasal Access to the Contralateral Orbit

Revuelta-Barbero,

Rodas,

Porto

et al. 2023

J Neurol Surg B Skull Base

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Objective This study aimed to objectively compare maneuverability at the contralateral medial orbit when approached through the traditional endoscopic endonasal approach (EEA) and EEA with transeptal window (TW). Study Design Anatomic dissections were performed bilaterally on three latex-injected cadaveric heads.  Approaches were performed sequentially; initially, an EEA was fashioned. Binostril access was achieved through a 2-cm posterior septectomy. The second stage pertained to the TW dissection. Area of exposure (AoE), surgical freedom (SF), and angles of attack (AoA) were measured along the contralateral medial orbital wall and compared for each approach. Additionally, the study presents an illustrative case describing the application of the EEA + TW for resection of an intraorbital schwannoma. Results Compared with EEA, EEA + TW yielded a significantly greater AoE along the contralateral medial orbital wall (39.45 vs. 48.45 cm2, respectively; p = 0.002). SF was statistically different between the EEA and EEA + TW (1153.25 vs. 2256.33 cm2, respectively; p = 0.002). AoA in the horizontal plane were significantly broader with the EEA + TW (6.36 vs. 4.9 degrees by EEA; p = 0.015).A 50-year-old male with a right medial extraconal orbital tumor was successfully treated through an EEA using the transeptal corridor to access the medial orbital region. No long-term complications were encountered after 31 months of follow-up. Conclusions EEA + TW is a minimally invasive technique that maximizes exposure and maneuverability within the medial orbital wall, allowing resection of lesions that extend anteriorly. EEA + TW limits disruption of the nasal septum and overcomes the obstacle that intranasal anatomy represents for instrumentation.

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Exploration of anatomical landmarks for performing an endoscopic transoral nasopharyngectomy

Jin

et al. 2022

Head & Neck

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Background Performing a nasopharyngectomy via a transoral approach has been reported; however, defining landmarks to facilitate this approach has not been addressed. This study aims to explore anatomical landmarks to aid in performing a nasopharyngectomy via the transoral corridor. Methods An endoscopic transoral nasopharyngectomy was performed on six cadaveric specimens (12 sides). Related anatomical landmarks were defined, and the strategy to preserve the parapharyngeal internal carotid artery (pICA) was explored. Results An endoscopic transoral nasopharyngectomy was successfully achieved in all 12 sides. Utilizing the pterygoid hamulus as a landmark, the cartilaginous ET and attachments could be adequately exposed. Identification of the pICA is a prerequisite prior to Eustachian tube (ET) transection. The sphenoidal spine and the petrotympanic fissure could be sufficiently revealed in all 12 sides, which aided in transection of the cartilaginous ET without pICA injury. The ET and the prevertebral contents could be adequately removed via the transoral corridor. Conclusion The pterygoid hamulus, sphenoidal spine and petrotympanic fissure serve as reliable landmarks for performing a transoral nasopharyngectomy. Identification of the pICA is a prerequisite prior to transection of the ET to avoid pICA injury.

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Endoscopic transoral nasopharyngectomy

Cited by 5 publications

References 32 publications

Endoscopic endonasal combined transoral medial approach to the nasopharynx, parapharyngeal space, and jugular foramen

Endoscopic endonasal combined transoral medial approach to the nasopharynx, parapharyngeal space, and jugular foramen

The Role of the Transeptal Window in Endoscopic Endonasal Access to the Contralateral Orbit

Exploration of anatomical landmarks for performing an endoscopic transoral nasopharyngectomy

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