The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Ricardo L Carrau - One of the best experts on this subject based on the ideXlab platform.
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transoral surgical anatomy and clinical considerations of lateral oropharyngeal wall Parapharyngeal Space and tongue base
Otolaryngology-Head and Neck Surgery, 2016Co-Authors: Ricardo L Carrau, Kasim Durmus, Ramazan Gun, Cuneyt Kucur, Enver OzerAbstract:ObjectiveWith 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.Study DesignDescriptive transoral anatomic study.SettingAcademic anatomy laboratory and tertiary academic hospital.Subjects and MethodsTransoral 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.ResultsThe neurovascular and muscular structures located in Parapharyngeal Space, lateral oropharyngeal wall, and base of tongue were described. Surgical significance of ke...
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access to the Parapharyngeal Space an anatomical study comparing the endoscopic and open approaches
Laryngoscope, 2013Co-Authors: Jason Van Rompaey, Ricardo L Carrau, Anand Suruliraj, Benedict Panizza, Arturo C SolaresAbstract:Objectives/HypothesisA subtemporal preauricular approach to the infratemporal fossa and Parapharyngeal Space has been the traditional path to tumors of this region. The morbidity associated with this procedure has lead to the pursuit of less invasive techniques. Endoscopic access using a minimally invasive transmaxillary/transpterygoid approach potentially may obviate the drawbacks associated with open surgery. The anatomy of the Parapharyngeal Space is complex and critical; therefore, a comparison of the anatomy exposed by these different approaches could aid in the decision making toward a minimally invasive surgical corridor.
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management of tumors of the Parapharyngeal Space
Oncology, 1997Co-Authors: Ricardo L Carrau, Jonas T Johnson, Eugene N MyersAbstract:Benign and malignant tumors can arise from any of the structures contained within the Parapharyngeal Space. Such tumors are very rare, however. Also, malignant tumors from adjacent areas (eg, the pharynx) can extend into the Parapharyngeal Space by direct growth, or distant tumors may metastasize to the lymphatics within the Space. Although the history and physical examination can provide clues to the site of origin and nature of a Parapharyngeal Space tumor, imaging studies are more useful for defining the site of origin and extent of the mass, as well as its vascularity and relationship to the great vessels of the neck and other neurovascular structures. Surgery is the mainstay of treatment. The surgical approach chosen should facilitate complete tumor extirpation with minimal morbidity. Irradiation is administered as primary therapy in patients with unresectable tumors, poor surgical candidates, and selected other patients. Radiation therapy is also used after surgery for high-grade malignancies or when wide surgical margins cannot be achieved.
Enver Ozer - One of the best experts on this subject based on the ideXlab platform.
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transoral surgical anatomy and clinical considerations of lateral oropharyngeal wall Parapharyngeal Space and tongue base
Otolaryngology-Head and Neck Surgery, 2016Co-Authors: Ricardo L Carrau, Kasim Durmus, Ramazan Gun, Cuneyt Kucur, Enver OzerAbstract:ObjectiveWith 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.Study DesignDescriptive transoral anatomic study.SettingAcademic anatomy laboratory and tertiary academic hospital.Subjects and MethodsTransoral 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.ResultsThe neurovascular and muscular structures located in Parapharyngeal Space, lateral oropharyngeal wall, and base of tongue were described. Surgical significance of ke...
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transoral robotic resection of selected Parapharyngeal Space tumors
European Archives of Oto-rhino-laryngology, 2013Co-Authors: Hassan Arshad, Kasim Durmus, Enver OzerAbstract:Currently, transoral robotic surgery (TORS) with the daVinci robot is mainly used for squamous cell carcinoma of the oropharynx and supraglottic larynx. The safety, efficacy, and functional outcomes regarding this approach have previously been described. In addition to transoral resection of squamous cell carcinoma, we have found use for this technique in removing selected tumors of the Parapharyngeal Space. Three patients with benign or malignant tumors of the Parapharyngeal Space who underwent successful transoral resection using the daVinci robot were included in the study. In all three cases, complete tumor excision was achieved without any complication. None required conversion to an open procedure. Mean TORS operative time and intraoperative blood loss were 16.3 min and 4.7 mL, respectively. Inadequate oral exposure, involvement of the internal carotid artery, limited cervical spine mobility and large tumor size are the main limitations of this approach. Result indicates that magnified view, 3D visualization with the combination of the transoral robotic experience, allow en bloc resection of selected Parapharyngeal Space tumors located medial to the carotid sheath.
Kaoru Ogawa - One of the best experts on this subject based on the ideXlab platform.
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modified endoscopic transnasal transmaxillary transpterygoid approach to Parapharyngeal Space tumor resection
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2016Co-Authors: Koichiro Wasano, Sayuri Yamamoto, Shuta Tomisato, Taiji Kawasaki, Kaoru OgawaAbstract:Background Conventional approaches for removing Parapharyngeal Space tumors require a cervical skin incision and resection of soft tissues between the skin and Parapharyngeal Space. The surgical visual field for this conventional approach is limited. Methods To decrease invasiveness during removal of benign Parapharyngeal Space tumors and to enhance the visual field, we devised a new approach called the modified endoscopic transnasal-transmaxillary-transpterygoid approach (MENMAP). The "surgical corridor" to the Parapharyngeal Space consists of the maxillary sinus, submucous tunnel under the lateral nasal wall, and the Space created by removing the pterygoid process. Results We successfully performed en bloc removal of a Parapharyngeal Space tumor using the MENMAP approach. The only surgical complication was hypoesthesia of the right hard palate and maxillary gingiva, which gradually improved. Conclusion The MENMAP approach is a viable alternative for removing Parapharyngeal Space tumors, as it is safe, feasible, and less invasive. © 2016 Wiley Periodicals, Inc. Head Neck 38: 933-938, 2016.
Arturo C Solares - One of the best experts on this subject based on the ideXlab platform.
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access to the Parapharyngeal Space an anatomical study comparing the endoscopic and open approaches
Laryngoscope, 2013Co-Authors: Jason Van Rompaey, Ricardo L Carrau, Anand Suruliraj, Benedict Panizza, Arturo C SolaresAbstract:Objectives/HypothesisA subtemporal preauricular approach to the infratemporal fossa and Parapharyngeal Space has been the traditional path to tumors of this region. The morbidity associated with this procedure has lead to the pursuit of less invasive techniques. Endoscopic access using a minimally invasive transmaxillary/transpterygoid approach potentially may obviate the drawbacks associated with open surgery. The anatomy of the Parapharyngeal Space is complex and critical; therefore, a comparison of the anatomy exposed by these different approaches could aid in the decision making toward a minimally invasive surgical corridor.
Dan M Fliss - One of the best experts on this subject based on the ideXlab platform.
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the transcervical approach for Parapharyngeal Space pleomorphic adenomas indications and technique
PLOS ONE, 2014Co-Authors: Gilad Horowitz, Oded Benari, Oshri Wasserzug, Noam Weizman, Moshe Yehuda, Dan M FlissAbstract:Background Head and Neck Parapharyngeal Space tumors are rare. Pleomorphic Adenomas are the most common Parapharyngeal Space tumors. The purpose of this study was to define preoperative criteria for enabling full extirpation of Parapharyngeal Space pleomorphic adenomas via the transcervical approach while minimizing functional and cosmetic morbidity. Methods The surgical records and medical charts of 19 females and 10 males with Parapharyngeal Space pleomorphic adenomas operated between 1993 and 2012 were reviewed. Results Fifteen patients were operated by a simple transcervical approach, 13 by a transparotid transcervical approach, and one by a transmandibular transcervical approach. Complications included facial nerve paralysis, infection, hemorrhage and first bite syndrome. There were three recurrences, but neither recurrence nor complications were associated with the type of surgical approach. Conclusion A simple transcervical approach is preferred for Parapharyngeal Space pleomorphic adenomas with narrow attachments to the deep lobe of the parotid gland and for pleomorphic adenomas originating in a minor salivary gland within the Parapharyngeal Space.
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surgical management of Parapharyngeal Space tumors a 10 year review
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Avi Khafif, Yoram Segev, Daniel M Kaplan, Ziv Gil, Dan M FlissAbstract:OBJECTIVE: The purpose of this article is to describe the diagnostic evaluation and surgical approaches to Parapharyngeal Space tumors in a tertiary referral center. STUDY DESIGN AND SETTING: The study is a retrospective review of 47 patients diagnosed with tumors of the Parapharyngeal Space (12 with malignant diseases and 35 with benign lesions) and surgically treated during a 10-year period. The transcervical (40%) and the transcervical-transparotid approaches (46%) were the most commonly performed surgical procedures followed by the orbitozygomatic-middle fossa approach (12%) and the transmandibular approach (2%). RESULTS: The surgical procedures were uneventful and there were no postoperative mortalities. Complications were rare; the most common was transient facial nerve paralysis (5 patients). After an average follow-up of 35 months, only 1 of 35 patients with benign diseases had a recurrence 5 years following transcervical resection of a pleomorphic adenoma. Of 12 patients with malignant tumors, 5 (42%) are alive with no evidence of disease. The sensitivity of preoperative fine needle aspiration biopsy (n = 23 patients) was 87% for detection of malignant disease and specificity was 100%. CONCLUSIONS: Most benign Parapharyngeal Space tumors can be removed surgically with a low rate of complications and recurrence. Malignant neoplasms, however, carry an ominous prognosis and a low rate of disease-free survival. Fine needle aspiration may be helpful in preoperative diagnostic evaluation of patients with Parapharyngeal Space tumors.