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Transoral robotic approaches to parapharyngeal space malignancies: a systematic review

Published online by Cambridge University Press:  02 January 2026

Francesco Chiari Open the ORCID record for Francesco Chiari [Opens in a new window] ,
Daria Maria Filippini ,
Edoardo Serafini Open the ORCID record for Edoardo Serafini [Opens in a new window] ,
Matteo Fermi ,
Livio Presutti ,
Antonino Maniaci Open the ORCID record for Antonino Maniaci [Opens in a new window] ,
Claudio Donadio Caporale  and
Pierre Guarino
Francesco Chiari*
Affiliation:
Otolaryngology Head and Neck Unit - “Santo Spirito” Hospital, Pescara Hospital, Pescara, Italy
Daria Maria Filippini
Affiliation:
Medical Oncology Unit - IRCCS Azienda Ospedaliero Universitaria di Bologna, Italy
Edoardo Serafini
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
Matteo Fermi
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy
Livio Presutti
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy
Antonino Maniaci
Affiliation:
Department of Surgery, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Belgium Department of Medicine and Surgery, University of Enna “Kore”, Italy
Claudio Donadio Caporale
Affiliation:
Otolaryngology Head and Neck Unit - “Santo Spirito” Hospital, Pescara Hospital, Pescara, Italy
Pierre Guarino
Affiliation:
Otolaryngology Head and Neck Unit - “Santo Spirito” Hospital, Pescara Hospital, Pescara, Italy
*
Corresponding author: Francesco Chiari; Email: francesco.chiari.med@gmail.com
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Abstract

Objective

Transoral robotic surgery (TORS) has emerged as a promising alternative to conventional open approaches for parapharyngeal space malignancies. This review aimed to evaluate the surgical indications, oncologic efficacy and functional outcomes of robotic-assisted procedures.

Methods

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines. PubMed, Scopus and Cochrane databases were searched for studies published between 2007 and 2025. Eligible studies included patients with parapharyngeal space malignancies managed by transoral robotic surgery or combined transoral robotic surgery–open approaches.

Results

Eleven studies, comprising 20 patients, met the inclusion criteria. Ten patients underwent transoral robotic surgery-only resection, with no intra-operative or post-operative complications and no evidence of recurrence during follow-up. Eight patients were treated with combined transoral robotic surgery–open approaches, achieving comparable oncologic control, albeit with a higher rate of tracheostomy and feeding tube placement.

Conclusion

Transoral robotic surgery-only represents a valid strategy for selected small and well-localised parapharyngeal space malignancies, ensuring favourable oncologic and functional outcomes. Combined transoral robotic surgery–open approaches expand surgical indications to larger and anatomically complex tumours, while maintaining acceptable morbidity and oncologic results.

Keywords

head and neck neoplasmsneck dissectionparapharyngeal spacerobotic surgical procedures

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 140 , Issue 4 , April 2026 , pp. 414 - 422
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Francesco Chiari takes responsibility for the integrity of the content of the paper

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