TRANS-ORAL ROBOTIC SURGERY: AN ALTERNATIVE TECHNIQUE FOR THE TREATMENT OF PLEOMORPHIC ADENOMAS OF THE PARAPHARYNGEAL SPACE
Authors:
Giulia Togo1, Luigi Califano1, Franco Ionna1, Giovanni Salzano2
Affiliation:
1 Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological sciences, University Federico II, Naples, Italy
2 Division of Maxillo-Facial and ENT Oncological Surgery, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
Doi: 10.54936/haoms242p78
ABSTRACT:
Objectives: The aim of this study has been to describe our experience with pleomorphic adenomas of the parapharyngeal space (PPS) treated through Trans-oral Robotic Surgery (TORS). Tumours arising from the PPS comprise less than 0.5% of all head and neck tumours. Salivary gland tumours account for 40–50% of PPS lesions with pleomorphic adenomas representing the most common tumours (80– 90%).
Materials and Methods: This study is a retrospective review of the clinical records of 14 patients treated for a PPS tumour by TORS. The same pre-operatory workflow was applied for each patients: a fine needle aspiration biopsy and a magnetic resonance imaging (MRI) were performed. The results were used to plan the correct surgical approach. Post-operative MRI was performed at 6 months after surgery in accordance with our protocol.
Results: In 13 cases (93%), TORS allowed the integrity of the tumour capsule to be preserved, with a successful separation from the para-pharyngeal structures. In one case a rupture of the lesion capsule occurred, but the 6 month post-surgery MRI showed no recurrence of the disease.
Conclusion: Our experience indicates that TORS is a safe surgical procedure able to perform a minimally invasive excision of benign tumours of the PPS in selected cases. The 360° motion of the robotic system, the three-dimensional high definition visualization and the reduction of hand tremors allow a good manipulation of the tissues, a clear identification of the tumour capsule and a precise dissection of the tumour, with no apparent capsule fragmentation. Furthermore, TORS allows an optimal control of haemostasis, which is more difficult to obtain with others access. A pre-operative diagnosis and careful patient selection is necessary to reduce surgical morbidity.
KEY WORDS: Trans-oral Robotic Surgery (TORS), Pleomorphic Adenoma, Parapharyngeal Space, Salivary Glands
Authors:
Giulia Togo1, Luigi Califano1, Franco Ionna1, Giovanni Salzano2
Affiliation:
1 Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological sciences, University Federico II, Naples, Italy
2 Division of Maxillo-Facial and ENT Oncological Surgery, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
Doi: 10.54936/haoms242p78
ABSTRACT:
Objectives: The aim of this study has been to describe our experience with pleomorphic adenomas of the parapharyngeal space (PPS) treated through Trans-oral Robotic Surgery (TORS). Tumours arising from the PPS comprise less than 0.5% of all head and neck tumours. Salivary gland tumours account for 40–50% of PPS lesions with pleomorphic adenomas representing the most common tumours (80– 90%).
Materials and Methods: This study is a retrospective review of the clinical records of 14 patients treated for a PPS tumour by TORS. The same pre-operatory workflow was applied for each patients: a fine needle aspiration biopsy and a magnetic resonance imaging (MRI) were performed. The results were used to plan the correct surgical approach. Post-operative MRI was performed at 6 months after surgery in accordance with our protocol.
Results: In 13 cases (93%), TORS allowed the integrity of the tumour capsule to be preserved, with a successful separation from the para-pharyngeal structures. In one case a rupture of the lesion capsule occurred, but the 6 month post-surgery MRI showed no recurrence of the disease.
Conclusion: Our experience indicates that TORS is a safe surgical procedure able to perform a minimally invasive excision of benign tumours of the PPS in selected cases. The 360° motion of the robotic system, the three-dimensional high definition visualization and the reduction of hand tremors allow a good manipulation of the tissues, a clear identification of the tumour capsule and a precise dissection of the tumour, with no apparent capsule fragmentation. Furthermore, TORS allows an optimal control of haemostasis, which is more difficult to obtain with others access. A pre-operative diagnosis and careful patient selection is necessary to reduce surgical morbidity.
KEY WORDS: Trans-oral Robotic Surgery (TORS), Pleomorphic Adenoma, Parapharyngeal Space, Salivary Glands