Original ArticlesThe Role of Transoral Robotic Surgery for Parapharyngeal Space Experience of a Tertiary CenterChu, Francesco MD*; De Berardinis, Rita MD†; Tagliabue, Marta MD*; Zorzi, Stefano MD*; Bandi, Francesco MD‡; Ansarin, Mohssen MD*Author Information *Department of Otolaryngology–Head and Neck Surgery, European Institute of Oncology IRCCS, Milan †Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome ‡Department of Otorhinolaryngology, Circolo Hospital and Macchi Foundation, University of Insubria, Varese, Italy. Address correspondence and reprint requests to Mohssen Ansarin, MD, Chief of Department of Otolaryngology Head and Neck Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy; E-mail: email@example.com Received 4 June, 2019 Accepted 11 July, 2019 Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com). The authors report no conflicts of interest. Journal of Craniofacial Surgery: January/February 2020 - Volume 31 - Issue 1 - p 117-120 doi: 10.1097/SCS.0000000000005912 Buy SDC Metrics Abstract The parapharyngeal space (PPS) is an anatomically and functionally complex region of the craniofacial district. Tumors that originate from this region are rare, and surgery is currently the best practice in the vast majority of cases with different surgical approaches being reported in the literature. Recently, mini-invasive robotic/endoscopic techniques have begun to emerge as effective alternatives in selected cases. In this work, we retrospectively analyzed 17 patients affected by PPS tumors, and managed by transoral robotic surgery (TORS) as a therapeutic or diagnostic procedure. TORS was used alone or combined with a transcervical approach for huge lesions of the PPS, at risk of fragmentation (curative intent). TORS also permitted biopsies of unknown lesions of the PPS to be conducted (diagnostic intent) otherwise unreachable without performing a mandibulotomy. All patients treated with curative intent benefited from radical surgery. No major complications were observed, and tumor fragmentation occurred only in 2 of 17 patients (11.8%). All patients receiving TORS with diagnostic intent were successfully referred to nonsurgical treatments based on the final histhopathological findings. This work also demonstrated TORS to be effective and safe on a larger group of patients compared to our preliminary study in 2016. TORS provides good oncological and functional outcomes when used with curative intent and is an effective diagnostic tool in cases of suspicious lesions of the PPS. © 2020 by Mutaz B. Habal, MD.