TY - JOUR
T1 - Endoscopic-assisted multi-portal compartmental resection of the masticatory space in oral cancer
T2 - Anatomical study and preliminary clinical experience
AU - Schreiber, Alberto
AU - Mattavelli, Davide
AU - Accorona, Remo
AU - Rampinelli, Vittorio
AU - Ferrari, Marco
AU - Grammatica, Alberto
AU - Tomacelli, Giovanni Leo
AU - Verzeletti, Vincenzo
AU - Fazio, Enrico
AU - Abousiam, Monir
AU - Nebiaj, Aurel
AU - Deganello, Alberto
AU - Nicolai, Piero
AU - Buffoli, Barbara
AU - Rezzani, Rita
AU - Piazza, Cesare
AU - Calabrese, Luca
N1 - Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/6
Y1 - 2021/6
N2 - Objectives: To present an anatomical cadaver dissection study and our preliminary surgical experience with endoscopic-assisted multi-portal compartmental resection of the masticatory space (MS) in locally advanced oral squamous cell carcinoma (OSCC) of the retromolar area. Materials and methods: Two fresh-frozen cadaver heads were dissected in the Laboratory of Anatomy to define the surgical steps of an endoscopic-assisted multi-portal compartmental approach to the MS. After this preclinical anatomical study, patients affected by locally advanced OSCC originating from the retromolar area with extension to the MS were prospectively enrolled and operated at two Italian referral centers for head and neck cancer between October 2019 and May 2020. Results: Surgical technique of endoscopic-assisted multi-portal compartmental resection of the MS was preclinically defined step by step in 3 phases: transnasal, transoral/trancervical, and multi-portal. Compartmental resection of the MS was successfully completed in all specimens (4 MSs dissected). The surgical technique was subsequently applied in 3 patients affected by primary OSCC of the retromolar area, providing satisfactory results in terms of negative resection margins and local control. Conclusions: Multi-portal compartmental resection of the MS combining the transnasal and transoral/transcervical corridors is technically feasible. Such an approach to the MS in locally advanced OSCC provides different angles of incidence to the target and full control of tumor margins.
AB - Objectives: To present an anatomical cadaver dissection study and our preliminary surgical experience with endoscopic-assisted multi-portal compartmental resection of the masticatory space (MS) in locally advanced oral squamous cell carcinoma (OSCC) of the retromolar area. Materials and methods: Two fresh-frozen cadaver heads were dissected in the Laboratory of Anatomy to define the surgical steps of an endoscopic-assisted multi-portal compartmental approach to the MS. After this preclinical anatomical study, patients affected by locally advanced OSCC originating from the retromolar area with extension to the MS were prospectively enrolled and operated at two Italian referral centers for head and neck cancer between October 2019 and May 2020. Results: Surgical technique of endoscopic-assisted multi-portal compartmental resection of the MS was preclinically defined step by step in 3 phases: transnasal, transoral/trancervical, and multi-portal. Compartmental resection of the MS was successfully completed in all specimens (4 MSs dissected). The surgical technique was subsequently applied in 3 patients affected by primary OSCC of the retromolar area, providing satisfactory results in terms of negative resection margins and local control. Conclusions: Multi-portal compartmental resection of the MS combining the transnasal and transoral/transcervical corridors is technically feasible. Such an approach to the MS in locally advanced OSCC provides different angles of incidence to the target and full control of tumor margins.
KW - Advanced oral cancer
KW - Compartmental surgery
KW - Endoscopic endonasal surgery
KW - Infratemporal fossa
KW - Masticatory space
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U2 - 10.1016/j.oraloncology.2021.105269
DO - 10.1016/j.oraloncology.2021.105269
M3 - Article
C2 - 33827034
AN - SCOPUS:85103717885
VL - 117
JO - Oral Oncology
JF - Oral Oncology
SN - 1368-8375
M1 - 105269
ER -