title: Transoral Surgical Anatomy and Clinical Considerations of Lateral Oropharyngeal Wall, Parapharyngeal Space, and Tongue Base.
abstract: OBJECTIVE
  With the emergence of transoral robotic approaches, head and neck surgeons are faced with an unfamiliar inside-out head and neck anatomy. This study was performed to describe key anatomic landmarks and surgical considerations of transoral robotic resection of the lateral oropharyngeal wall, the parapharyngeal space, and the base of the tongue.
  
  
  METHODS
  Descriptive transoral anatomic study.
  
  
  METHODS
  Academic anatomy laboratory and tertiary academic hospital.
  
  
  METHODS
  Transoral dissections of the lateral pharyngeal wall, base of tongue, and parapharyngeal space were performed in 5 vascular silicone-injected cadavers to illustrate anatomic landmarks from the inside-out perspective. Lateral neck dissections were also performed to better appreciate the anatomic structures and to be more familiar with intraoperative anatomy.
  
  
  RESULTS
  The neurovascular and muscular structures located in parapharyngeal space, lateral oropharyngeal wall, and base of tongue were described. Surgical significance of key anatomic landmarks was emphasized with high-quality illustrations.
  
  
  CONCLUSIONS
  A thorough understanding of transoral anatomy is crucial to perform transoral robotic surgery safely and efficiently. To understand inside-out anatomy of base of tongue, lateral oropharyngeal wall, and parapharyngeal space, cadaveric dissection is highly beneficial and may help to shorten the learning curve for transoral robotic dissections.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Dicle University, Diyarbakir, Turkey drgunkbb@yahoo.com Ramazan.Gun@osumc.edu.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Gun
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Kasim
authors.initials: K
authors.lastname: Durmus
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Dumlupinar University, Kutahya, Turkey.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Kucur
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Carrau
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Enver
authors.initials: E
authors.lastname: Ozer
mesh_terms: D059925:Anatomic Landmarks; D002102:Cadaver; D006801:Humans; D037981:Neck Dissection; D009960:Oropharynx / Q000033:anatomy & histology; D013517:Otorhinolaryngologic Surgical Procedures; D010614:Pharynx / Q000033:anatomy & histology*; D065287:Robotic Surgical Procedures; D014059:Tongue / Q000033:anatomy & histology*
keywords: TORS; anatomic landmarks; base of tongue; lateral pharyngeal wall; parapharyngeal space