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Anatomical studies and early results on endoscopic transoral medial pterygomandibular fold approach to salvage retropharyngeal lymphadenectomy in nasopharyngeal carcinoma

Published online by Cambridge University Press:  17 November 2023

Kai Xue ,
Juan Liu Open the ORCID record for Juan Liu [Opens in a new window] ,
Qiang Liu ,
Huan-Kang Zhang ,
Quan Liu ,
Jing Li ,
Xiao-Wen Jiang ,
Ke-Qing Zhao ,
Ye Gu  and
Xiao-Le Song
...Show all authors
Kai Xue
Affiliation:
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Juan Liu
Affiliation:
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Qiang Liu
Affiliation:
Department of Radiology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Huan-Kang Zhang
Affiliation:
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Quan Liu
Affiliation:
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Jing Li
Affiliation:
Department of Otolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
Xiao-Wen Jiang
Affiliation:
Department of Otolaryngology, Huazhong University of Science and Technology Union Hospital (Nanshan Hospital), Shenzhen City, PR China
Ke-Qing Zhao
Affiliation:
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Ye Gu
Affiliation:
Department of Neurosurgery, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Xiao-Le Song
Affiliation:
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Xi-Cai Sun*
Affiliation:
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, PR China
Hong-Meng Yu
Affiliation:
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, PR China Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor (2018RU003), Chinese Academy of Medical Sciences, Shanghai, PR China
*
Corresponding author: Xi-Cai Sun; Email: [email protected]
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Abstract

Objective

Retropharyngeal lymphadenectomy is challenging. This study investigated a minimally invasive approach to salvage retropharyngeal lymphadenectomy in patients with nasopharyngeal carcinoma.

Methods

An anatomical study of four fresh cadaveric heads was conducted to demonstrate the relevant details of retropharyngeal lymphadenectomy using the endoscopic transoral medial pterygomandibular fold approach. Six patients with nasopharyngeal cancer with retropharyngeal lymph node recurrence, who underwent retropharyngeal lymphadenectomy with the endoscopic transoral medial pterygomandibular fold technique at the Eye and ENT Hospital of Fudan University from July to December 2021, were included in this study.

Results

The anatomical study demonstrated that the endoscopic transoral medial pterygomandibular fold approach offers a short path and minimally invasive approach to the retropharyngeal space. The surgical procedure was well tolerated by all patients, with no significant post-operative complications.

Conclusion

The endoscopic transoral medial pterygomandibular fold approach is safe and efficient for retropharyngeal lymphadenectomy.

Keywords

Nasopharyngeal carcinomalymphatic metastasisrecurrencelymph node excisionoral surgical proceduresendoscopyinternal carotid artery
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 5 , May 2024 , pp. 540 - 547
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

*

Joint first authors

#

Contributed equally to this work as corresponding authors.

Xi-Cai Sun takes responsibility for the integrity of the content of the paper

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