title: Combined transnasal endoscopic and transoral robotic resection of recurrent nasopharyngeal carcinoma.
abstract: BACKGROUND
  We report a case of resecting a recurrent nasopharyngeal carcinoma using a combined technique of transoral robotic surgery and transnasal endoscopic surgery.
  
  
  METHODS
  A small recurrent tumor was located in the roof of the nasopharynx. The inferior part of the resection was performed with a da Vinci surgical robot transorally after splitting the soft palate to expose the nasopharynx. The superior part of the resection, including removal of the anterior wall and floor of the sphenoid was performed transnasally under endoscopic vision.
  
  
  RESULTS
  The tumor was removed enbloc with the sphenoid sinus wall with clear resection margin. Recovery was uneventful and the patient had minimal morbidity from the operation.
  
  
  CONCLUSIONS
  For minimally invasive surgery to resect recurrent nasopharyngeal carcinoma, transnasal endoscopic surgery and transoral robotic surgery compliments each other, allowing improved resection.
authors.affiliation: Division of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China. rkytsang@hku.hk.
authors.forename: Raymond King
authors.initials: RK
authors.lastname: Yin Tsang
authors.forename: Wai Kuen
authors.initials: WK
authors.lastname: Ho
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
mesh_terms: D002277:Carcinoma / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000601:surgery*; D009305:Nasopharynx / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012371:Robotics; D013101:Sphenoid Sinus / Q000601:surgery