Technical refinement of ultrasound‐guided transoral resection of parapharyngeal/retropharyngeal thyroid carcinoma metastases

Abstract

Transoral excision of PPS/RPS WDTC metastases with ultrasound-guided methylene blue dye injection into the metastatic node is safe, feasible, and may further improve intraoperative identification of metastases in poorly accessible locations in the head and neck.

Association between contrast-enhanced ultrasonography and histopathological findings of the metastatic lymph nodes of patients with head and neck cancer: A preliminary study

“…To allow accurate comparison of the cut surface of the surgical specimen with the section examined via ultrasound, intra-operative CEUS examination of the lymph node of interest was performed. Although a number of studies have evaluated intraoperative ultrasonography of the head and neck, the majority of them involved transoral surgery (14–16). A number of studies have investigated intraoperative evaluation of the cervical lymph nodes (17,18).…”

Ultrasound-Guided Transoral Videolaryngoscopic Surgery for Retropharyngeal Lymph Node Metastasis of Papillary Thyroid Cancer

“…These procedures carry rather high morbidity rates considering the relatively indolent nature of well-differentiated thyroid cancer [ 7 , 17 ]. Therefore, endoscopic-assisted transoral resection, including transoral robotic surgery for metastatic RPN from well-differentiated thyroid cancer, has recently been described [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Trans-oral robotic surgery and surgeon-performed trans-oral ultrasound for intraoperative location and excision of an isolated retropharyngeal lymph node metastasis of papillary thyroid carcinoma

“…In our case report, the retropharyngeal node was initially found on MRI though the patient subsequently underwent PET-CT as well as CT-guided biopsy. Trans-oral ultrasound guided FNA in the diagnosis of retropharyngeal metastasis has been well described by others and we hope to further pursue this application in conjunction with our radiology and pathology colleagues [10,18].…”

“…Pre-operative or intraoperative lateral or central neck SP-US provides real-time information about the presence of pathology and on anatomic relationships of pathology in relation to vital structures potentially allowing for a more targeted, safe, and less morbid surgery. More specifically, TO-US allows the differential application of pressure to the lesion retropharyngeal mass to determine its mobility with relation to the carotid artery, and TO-US-guided injection of dye into the lesion(s) of interest can also be performed for enhanced localization [10,18,19].…”

“…Surgical excision of isolated retropharyngeal lymph node metastases from WDTC has been well described via trans-cervical, trans-mandibular, and trans-oral approaches, including endoscopic-assisted trans-oral resection [5][6][7][8][9][10][11]. Trans-oral robotic surgery (TORS) has been described for excision of metastatic retropharyngeal lymph nodes of oropharyngeal carcinoma and of parapharyngeal space tumors, but never for an isolated retropharyngeal metastasis from WDTC [12][13][14][15][16].…”