Endoscopic-Assisted Transoral Approach (EATA) for Extracranial Tumors: A Multicentric Case Series

Endoscopic surgery is useful and helpful especially to access areas with limited visibility. The combination of this technique with innovative approaches could be the solution to improve quality of surgery and patients' outcome. This study aimed to illustrate how Endoscopic-Assisted Transoral Approach (EATA) can be used to successfully remove specific extracranial tumors with defined characteristics. Eleven patients with extracranial tumors underwent surgical resection using an EATA between 2003 and 2025. All patients underwent clinical examination and fiberoptic laryngoscopy. Preoperative CT and/or MRI was performed in all cases. All patients were successfully treated utilizing an EATA. Histological examination revealed nine parapharyngiomas, comprising five pleomorphic adenomas, two schwannomas, one ectopic thyroid gland, one lipoma, one masticator space schwannoma, and one nasopharyngeal pleomorphic adenoma. No intra-operative nor peri-operatory complications were observed. The only long-term sequela observed was Horner's syndrome in the two schwannomas originating from the parapharyngeal-carotid space. The mean hospital stay was 2.6 days, while the mean follow-up duration was 9.8 years. The EATA represents a valid surgical technique for the treatment of benign, encapsulated, and non-vascular parapharyngeal space (PPS) tumors exhibiting posterior displacement of major vessels. This approach may also prove beneficial for the management of other benign, encapsulated, and non-vascular tumors located in the nasopharynx and masticator space.