title: Transoral approach to the superomedial parapharyngeal space.
abstract: OBJECTIVE
  To present our early experience with the transoral approach to the superomedial parapharyngeal space (PPS) and describe our technique for removal of these neoplasms.
  
  
  METHODS
  Consecutive case series by one author (Y.D.).
  
  
  METHODS
  Eight patients with various neoplasms of the superomedial PPS were retrospectively reviewed for type of neoplasm, size, success with the transoral approach, need for conversion to another approach, length of hospitalization, and complications.
  
  
  RESULTS
  The transoral approach described herein safely allowed for en bloc resection of benign neoplasms with intraoperative control and exposure of the internal carotid artery. The most common pathology encountered was that of schwannoma. All patients were started on liquid diet on postoperative day 1. Average length of stay was 3.2 days (range, 2 to 5). Mean tumor size was 3.3 cm (range, 1.5 to 7 cm). No significant complications were felt to be related to the approach itself and visualization was felt to be excellent in each case without the need for conversion to a more extensive approach.
  
  
  CONCLUSIONS
  The transoral approach safely provides access to superomedial PPS lesions with decreased morbidity compared with traditional approaches. This technique is indicated for neoplasms with benign appearance on preoperative imaging or fine needle aspiration. This approach alone may not provide adequate access for resection of malignant lesions especially those with extension intracranially or to more inferior or laterally placed lesions of the parapharyngeal space.
  
  
  METHODS
  C-4.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA. yducic@sbcglobal.net
authors.forename: Yadranko
authors.initials: Y
authors.lastname: Ducic
authors.forename: Lance
authors.initials: L
authors.lastname: Oxford
authors.forename: Allison T
authors.initials: AT
authors.lastname: Pontius
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002343:Carotid Artery, Internal / Q000473:pathology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000601:surgery*; D009361:Neoplasm Invasiveness; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013724:Teratoma / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome