Trans-Oral Robotic Surgery: 14 Cases of Pleomorphic Adenoma of the Parapharyngeal Space

Purpose: The aim of this study has been to describe our experience with pleomorphic adenomas of the parapharyngeal space (PPS) treated with trans-oral robotic surgery (TORS). Tumors arising from the PPS comprise less than 0.5% of all head and neck tumors. Salivary gland tumors account for 40% to 50% of PPS lesions with pleomorphic adenomas representing the most common salivary tumors (80%–90%). Parapharyngeal space tumors cause nonspecific symptoms and may be difficult to diagnose. Methods: In our study a preoperative diagnosis was conducted by fine needle aspiration biopsy and magnetic resonance imaging and the results were used to plan the correct surgical approach. Results: In all cases we were able to employ TORS, a minimally invasive procedure that allows us to operate in narrow and anatomically complex spaces that we can only reach thanks to the use of well-articulated hand pieces. Conclusions: This report indicates that TORS is a safe surgical procedure for the excision of benign tumors of the PPS in selected cases.

[1]  F. Merolla,et al.  Low-Grade Intraductal Carcinoma of the Parotid Gland: A Case Report and Literature Review , 2021, Head and Neck Pathology.

[2]  V. Abbate,et al.  Malignant tumours of the parotid gland: management of the neck (including the clinically negative neck) and a literature review. , 2020, The British journal of oral & maxillofacial surgery.

[3]  M. Cassano,et al.  Management of Parapharyngeal Space Tumor Using Transoral Robotic Surgery: The Tonsillar Fossa Battlefield. , 2020, The Journal of craniofacial surgery.

[4]  A. De Virgilio,et al.  Trans-oral robotic surgery in the management of parapharyngeal space tumors: A systematic review. , 2020, Oral oncology.

[5]  Suresh C. Sharma,et al.  Transoral robotic surgery for the parapharyngeal space: expanding the transoral corridor , 2020, Journal of robotic surgery.

[6]  C. Liao,et al.  Parapharyngeal space tumors: a serial case study , 2019, The Journal of international medical research.

[7]  S. van Weert,et al.  Tumors of the parapharyngeal space: the VU University Medical Center experience over a 20-year period , 2018, European Archives of Oto-Rhino-Laryngology.

[8]  J. Llorente,et al.  Parapharyngeal space primary tumours. , 2017, Acta otorrinolaringologica espanola.

[9]  V. Abbate,et al.  Use of the SMAS flap for reconstruction of the parotid lodge , 2015, Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale.

[10]  A. Mendelsohn.  Transoral robotic assisted resection of the parapharyngeal space , 2015, Head & neck.

[11]  D. Eisele,et al.  Transoral robotic surgery of the parapharyngeal space: A case series and systematic review , 2015, Head & neck.

[12]  E. Moore.  Robotic Surgery for the Management of Oropharyngeal Malignancies , 2015 .

[13]  G. Dell’Aversana Orabona,et al.  Surgical management of pleomorphic adenoma of parotid gland in elderly patients: role of morphological features. , 2014, International journal of surgery.

[14]  M. Mutlu,et al.  Pleomorphic Adenomas of the Parapharyngeal Space , 2014, Case reports in otolaryngology.

[15]  Matthew C. Miller,et al.  Preoperative cephalometric analysis to predict transoral robotic surgery exposure , 2014, Journal of Robotic Surgery.

[16]  L. Califano,et al.  Reconstructive Techniques of the Parotid Region , 2014, The Journal of craniofacial surgery.

[17]  Raghav C Dwivedi,et al.  A systematic review of 1143 parapharyngeal space tumors reported over 20 years. , 2014, Oral oncology.

[18]  V. Valentini,et al.  Parapharyngeal space benign tumours: our experience. , 2014, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[19]  Young Min Park,et al.  Parapharyngeal space surgery via a transoral approach using a robotic surgical system: transoral robotic surgery. , 2013, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[20]  G. Weinstein,et al.  Transoral robotic surgery for oropharyngeal carcinoma and its impact on patient‐reported quality of life and function , 2012, Head & neck.

[21]  T. Calcaterra,et al.  Parapharyngeal space pleomorphic adenoma: A 30‐year review , 2009, The Laryngoscope.

[22]  Mangal Singh,et al.  Our experiences with parapharyngeal space tumors and systematic review of the literature , 2009, Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India.

[23]  F. Ahmad,et al.  Management of parapharyngeal space tumours. , 2006, Journal of the College of Physicians and Surgeons--Pakistan : JCPSP.

[24]  Y. Segev,et al.  Surgical management of parapharyngeal space tumors: a 10-year review. , 2005, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.