Second branchial arch cysts are a common cause of cystic neck mass in adults. The type-IV variant of the second branchial arch cyst is uncommon and presents as a parapharyngeal space mass. It lies medial to the carotid sheath and it is not easily amenable to access by the traditional, trans-cervical approach to the parapharyngeal space. Trans-oral robotic surgery is a new application of the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, CA, USA). The system has only recently been approved by the FDA for trans-oral robotic resection of oropharyngeal cancers. The technology has since been used for new trans-oral applications, including resection of parapharyngeal space tumours. This is a case report of successful trans-oral robotic resection of a type IV second branchial arch cyst in the parapharyngeal space.
Branchial arch cysts Parapharyngeal space Trans-oral robotic surgery
We would like to thank the Nurse Assistants in the Robotic Theatres (Julie Bowd and Thembelihle Mazeka) and Operative Room Nurses of the Department of Otolaryngology, Head, and Neck Surgery at The Royal Adelaide Hospital. We especially would like to acknowledge Dr. Mallina Sivarajasingam for her assistance in publishing this case report.
Conflict of interest
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
Gourin CG, Johnson JT (2000) Incidence of unsuspected metastases in lateral cervical cysts. Laryngoscope 110(10 pt 1):1637–1641PubMedCrossRefGoogle Scholar
McLeod IK, Melder PC (2005) Da Vinci robot-assisted excision of a vallecular cyst: a case report. Ear Nose Throat J 84(3):170–172PubMedGoogle Scholar
Holsinger FC et al (2005) Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: I. technique, complications, and functional results. Arch Otolaryngol Head Neck Surg 131:583–591PubMedCrossRefGoogle Scholar
Kafif A, Segev Y, Kaplan DM et al (2005) Surgical management of parapharyngeal space tumors: a 10 year review. Otolaryngol Head Neck Surg 132:401–406CrossRefGoogle Scholar