4.5 Article

Endoscopic transoral nasopharyngectomy

Publisher

WILEY
DOI: 10.1002/hed.26483

Keywords

endoscopic; endoscopic transoral surgery; nasopharyngectomy; nasopharynx; skull base surgery; skull base surgery

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The study demonstrates the feasibility of endoscopic transoral nasopharyngectomy (ETON) for resection of large nasopharyngeal lesions, providing wide exposure of the skull base and proximal control of the internal carotid artery. It may be beneficial for managing nasopharyngeal tumors with inferolateral extension involving the internal carotid artery.
Background A minimal access technique for the management of nasopharyngeal tumors extending below the palatal plane and laterally beyond the pterygoid musculature is yet to be developed. In this study we demonstrate the feasibility of endoscopic transoral nasopharyngectomy (ETON) for resection of large nasopharyngeal lesions as a natural orifice alternative to traditional approaches. Methods ETON was completed in three latex-injected specimens. Surgical freedom (SF) and angles of attack (AoA) were calculated along the internal carotid artery (ICA). Results An endoscopic transoral approach was successfully used to identify the parapharyngeal ICA and subsequently perform a complete nasopharyngeal resection. SF and AoA (sagittal) were found to be the greatest at the anterior genu of the ICA. Conclusions ETON is feasible. It provides wide exposure of the skull base and proximal control of the ICA. It may be indicated for the management of nasopharyngeal tumors with inferolateral extension, involving the ICA.

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