Smith Joshua D, Chinn Steven B, Sridharan Shaum, Contrera Kevin J, Heft-Neal Molly E, Spector Matthew E
Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Otolaryngol Head Neck Surg. 2025 Jan;172(1):162-166. doi: 10.1002/ohn.976. Epub 2024 Oct 1.
We describe a novel technique for endoscope-assisted (EA) transcervical (TC) approach for resection of parapharyngeal space (PPS) tumors and compare perioperative outcomes of this approach to standard TC approaches.
Retrospective chart review.
Single tertiary care center.
This was a single-institution, retrospective analysis of all patients undergoing TC approach for resection of PPS tumors over a 10-year period. We describe unique advantages of our surgical approach utilizing a 0° endoscope for improved surgical access, visualization, and efficiency. χ and Student's t test were used to compare perioperative outcomes between cases in which an endoscope was utilized EA for resection versus standard TC approach.
Our cohort included 77 patients (n = 40 EA, n = 37 TC). There was no difference in patient age, sex, tumor laterality, tumor size, or tumor location between groups. The EA approach was associated with significantly shorter operative times (median [range] for EA 73 [33-270] minutes vs TC 112 [56-362] minutes, P < .01) and reduced rates of immediate postoperative marginal mandibular nerve paresis (EA: n = 5 [12.5%] vs TC: n = 16 [43.2%], P < 0.01).
EA TC approach for resection of PPS tumors offers improved surgical access and is associated with reduced surgical time and rates of marginal mandibular nerve paresis compared to standard transcervical approaches.
我们描述一种用于经颈(TC)入路切除咽旁间隙(PPS)肿瘤的新型内镜辅助(EA)技术,并将该入路的围手术期结果与标准TC入路进行比较。
回顾性病历审查。
单一的三级医疗中心。
这是一项对10年间所有接受TC入路切除PPS肿瘤患者的单机构回顾性分析。我们描述了使用0°内镜的手术方法的独特优势,以改善手术入路、可视化和效率。采用χ检验和学生t检验比较使用内镜辅助EA切除与标准TC入路病例的围手术期结果。
我们的队列包括77例患者(EA组n = 40,TC组n = 37)。两组患者的年龄、性别、肿瘤侧别、肿瘤大小或肿瘤位置无差异。EA入路的手术时间明显更短(EA组中位数[范围]为73[33 - 270]分钟,TC组为112[56 - 362]分钟,P < 0.01),术后即刻下颌缘支神经麻痹发生率降低(EA组:n = 5[12.5%],TC组:n = 16[43.2%],P < 0.01)。
与标准经颈入路相比,EA TC入路切除PPS肿瘤可提供更好的手术入路,且手术时间缩短,下颌缘支神经麻痹发生率降低。