Nasopharyngeal endoscopic resection in the management of selected malignancies: ten-year experience

Castelnuovo, Paolo; Dallan, Iacopo; Bignami, Maurizio; Battaglia, Paolo; Mauri, Sílvia; Villaret, Andrea Bolzoni; Bizzoni, Andrea; Tomenzoli, Davide; Nicolai, Piero

doi:10.4193/rhin09.079

Cited by 36 publications

(53 citation statements)

References 16 publications

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“…This 'endoscopic endonasal approach' (3,4) currently provides minimally invasive and adequate access to di erent skull base lesions. Recent anatomical studies (5)(6)(7) and clinical reports (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) have detailed and categorized this procedure into a series of anatomical modular approaches to the skull base, drawing on the pioneering, specialised and innovative work of Kassam, Carrau, and co-workers (10,(19)(20)(21) .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Esenat¹,

Notaris²,

Sanchez³

et al. 2013

Rhin

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Section: Introductionmentioning

confidence: 99%

Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Esenat¹,

Notaris²,

Sanchez³

et al. 2013

Rhin

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“…For this reason, we tried another solution in order to improve the easiness of the surgical procedure. Based on former experience in endoscopic transnasal techniques [9], we placed the endoscope transnasally. This idea is not new and has been previously described [10].…”

Section: Discussionmentioning

confidence: 99%

“…The major disadvantages of external approaches were related to their complexity, their high morbidity and the long hospital stay. More recently, endoscopic techniques have been proposed in alternative to external approaches [7][8][9], with promising results.…”

Section: Introductionmentioning

confidence: 99%

Combined transoral transnasal robotic-assisted nasopharyngectomy: a cadaveric feasibility study

Dallan

Castelnuovo

Montevecchi

et al. 2011

Eur Arch Otorhinolaryngol

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Surgical management of the nasopharynx is complex. Both traditional and endoscopic transnasal techniques are demanding. Purely transoral robotic nasopharyngectomy has been described but it needs a palatal splitting and is performed with an inferior to superior perspective with a difficult vision of the upper regions. The aim of this study is to investigate a new robotic surgical setting, which is able to overcome the actual limits. The DaVinci Surgical System was used in two cadavers. Dissection was carried out through a combined transnasal-transoral approach and a purely transoral procedure. A complete nasopharyngectomy was performed with both settings. Working and setting times are comparable. The combined approach avoids palatal spitting and permits a more panoramic view of the surgical field with an easier dissection of the upper areas. A robotic palatal sparing nasopharyngectomy is feasible. The combined transnasal-transoral setting seems to offer significant advantages with respect to traditionally purely transoral procedures.

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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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Nasopharyngeal endoscopic resection in the management of selected malignancies: ten-year experience

Abstract: NER is a feasible surgical technique that can be tailored in relation to tumour extension. Larger series and longer follow-up are needed to further validate the long-term results.

Cited by 36 publications

References 16 publications

Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Combined transoral transnasal robotic-assisted nasopharyngectomy: a cadaveric feasibility study

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

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