title: Transoral excision of a retropharyngeal lymph node under rigid endoscopic control.
abstract: Different traditional surgical approaches, such as transcervical, transparotid, and mandible-splitting procedures, have been described to expose the retropharyngeal space. The introduction of the transoral approach, in selected patients, provided a direct and adequate access to the retropharyngeal space, permitting a feasible and minimally invasive procedure to remove retropharyngeal lymph nodes. We report a case of a transoral video-assisted approach for the excision of a retropharyngeal lymph node in a young man who had previously been treated at another institution by surgery and radiotherapy for oral tongue cancer. The endoscopic magnification allowed us to perform a meticulous and relatively bloodless dissection of the lesion from the surrounding tissues with a clear identification of the anatomic structures, and therefore may represent a valid alternative to the use of a microscope or loupes to enhance vision. A clear understanding of the anatomy of the retropharyngeal space and a high degree of surgical expertise are required to perform a safe dissection of the lesion.
authors.affiliation: Department of Otorhinolaryngology, University of Brescia, Brescia, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Buttà
authors.forename: Davide
authors.initials: D
authors.lastname: Lombardi
authors.forename: Anna
authors.initials: A
authors.lastname: Marconi
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D019723:Endoscopes; D006801:Humans; D008197:Lymph Node Excision / Q000295:instrumentation / Q000379:methods*; D008297:Male; D012187:Retroperitoneal Space; D014062:Tongue Neoplasms / Q000473:pathology*; D020535:Video-Assisted Surgery / Q000379:methods