Transoral Robotic Surigical (TORS) Approaches to the Parapharyngeal Space, Hypopharynx and Larynx

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2025-05-18

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Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery

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University of Cape Town

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Abstract
In this chapter the authors describe the use of transoral robotic surgery (TORS) for pathology of the parapharyngeal space (PPS), hypopharynx, and larynx. The PPS is a complex anatomical space extending from the skull base to the level of the hyoid. Most tumours are benign and are traditionally accessed through transcervical and/or transparotid approaches due to the complex anatomy in this area. With technological advances, however, transoral approaches have regained popularity for selected tumours as they allow surgeons to avoid neck scars, and generally present less risk to cranial nerves compared to transcervical and transparotid approaches. TORS, with its high-fidelity 3D visualisation, magnification, lighting, and fully wristed instrumentation, has expanded the indications and popularity of the transoral approach. Herein we describe the relevant anatomy, indications, and surgical steps of the TORS approach to the PPS.
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