Transoral endoscopic anatomy of the parapharyngeal space: A step-by-step logical approach with surgical considerations
✍ Scribed by Iacopo Dallan; Veronica Seccia; Luca Muscatello; Riccardo Lenzi; Paolo Castelnuovo; Maurizio Bignami; Filippo Montevecchi; Manfred Tschabitscher; Claudio Vicini
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 212 KB
- Volume
- 33
- Category
- Article
- ISSN
- 1043-3074
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✦ Synopsis
Abstract
Background
Surgical approaches to the parapharyngeal spaces are challenging. Little is known about the transoral perspective of the anatomy of the parapharyngeal space. Thus, transoral approaches are seldom performed, and only for small‐sized tumors.
Methods
Six freshly injected cadaver heads were dissected to illustrate the transoral surgical anatomy of the parapharyngeal space.
Results
The transoral window dominates the parapharyngeal space from the medial pterygoid muscle laterally to the superior constrictor muscle medially. The stylopharyngeus and styloglossus muscles seem to be critical landmarks in this approach. Posterior to these muscles and laterally to the superior constrictor muscle, the internal carotid artery, internal jugular vein, and lower cranial nerves are identifiable.
Conclusion
This anatomic study emphasizes the critical role of the superior constrictor, styloglossus, and stylopharyngeus muscles and highlights the concept of a logical step by step technique that allows the identification of important structures and the creation of safe surgical corridors. © 2010 Wiley Periodicals, Inc. Head Neck, 2011