Abstract
Recent developments in surgical devices and techniques for transoral surgery, including transoral videolaryngoscopic surgery （TOVS）, have led to reports regarding transoral resection of tumors in the parapharyngeal space （PPS） and metastatic retropharyngeal lymph nodes （RPLNs）. In our institution, TOVS has been performed for six cases of PPS tumors and metastatic RPLNs, including for biopsy. Our experience, and reports from other institutions, suggest that the indications for transoral resection of PPS tumors and metastatic RPLNs may include: tumors located below the level of the hard palate and the pterygoid hamulus with protrusion toward the pharynx lumen, a single lesion without adhesion to the surrounding tissue, a tumor that is not highly vascularized, no history of irradiation, and a size of ＜7-8cm. Relative to the conventional transcervical approach, transoral resection may provide less operative trauma and a minimally invasive procedure, although ultrasonography, a nerve monitoring system, and a navigation system should be considered to minimize the risk of adverse events. Additional cases with long-term follow-up are needed to clarify the indications for transoral resection of PPS tumors and metastatic RPLNs.
