Sethi Neeraj, Dale Oliver, Vidhyadharan Sivakumar, Krishnan Suren, Foreman Andrew, Hodge J C
Department of Otolaryngology-Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Int J Med Robot. 2020 Jun;16(3):e2083. doi: 10.1002/rcs.2083. Epub 2020 Mar 5.
The advent of transoral robotic surgery (TORS) has allowed transoral approaches for parapharyngeal space (PPS) tumours to be re-evaluated. It provides enhanced visualisation and instrument access for appropriate tumours. We describe a specific technique, TORS narrow-field oropharyngectomy, that is ideal for benign PPS tumours which have been violated by intra-oral biopsy or incision and drainage. This allows the contaminated, overlying oropharyngeal mucosa to be resected en-bloc with the PPS tumour, reducing the risk of local recurrence. This technique provides a window into the PPS, improving visualisation of underlying neurovascular structures as well as the tumour. This reduces the risk of tumour spillage and leads to superior vascular access and haemorrhage control. This technique is only applicable to PPS tumours that are appropriate for transoral approaches and is specifically designed for those selected patients that have been placed at risk of seeding or local scarring by intra-oral procedures prior to definitive resection. We present two such cases: a 38-year-old male with a PPS inflammatory cyst and a 66-year-old female with a PSS pre-styloid Schwannoma.
经口机器人手术（TORS）的出现使得经口入路治疗咽旁间隙（PPS）肿瘤得以重新评估。它为合适的肿瘤提供了更好的视野和器械操作空间。我们描述了一种特定的技术，即TORS窄视野口咽切除术，该技术适用于因口腔内活检、切开引流而受侵犯的良性PPS肿瘤。这使得受污染的口咽黏膜能够与PPS肿瘤整块切除，降低局部复发风险。该技术为进入PPS提供了一个窗口，改善了对深部神经血管结构以及肿瘤的视野。这降低了肿瘤播散的风险，并实现了更好的血管显露和出血控制。该技术仅适用于适合经口入路的PPS肿瘤，并且是专门为那些在确定性切除前因口腔内操作而有种植或局部瘢痕形成风险的特定患者设计的。我们展示了两例这样的病例：一例是患有PPS炎性囊肿的38岁男性，另一例是患有茎突前PSS神经鞘瘤（原文有误，推测应为PPS）的66岁女性。
