{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:03:48Z","timestamp":1762866228851},"reference-count":9,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,9,19]],"date-time":"2013-09-19T00:00:00Z","timestamp":1379548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate the transoral anatomy of the tonsillar fossa and lateral pharyngeal wall and to correlate these findings with radiographic measurements and transoral robotic surgery (TORS) of patients with early tonsillar tumor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Preclinical cadaveric study and patient cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Six complete cadaveric dissections were performed to identify key anatomic landmarks, and these landmarks were validated in two consecutive patients with T1 human papillomavirus\u2013positive squamous cell carcinoma of the tonsil treated by TORS. For radiographic landmark analysis, 25 patients who underwent contrast\u2010enhanced computed tomography (CT) of the neck for a variety of endoscopic skull base procedures were selected. Measurements were taken from the lateral pharyngeal wall at C2\u2010C3 interspace and greater horn of hyoid (C6) to the external carotid artery (ECA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The glossopharyngeal (IX) nerve was consistently identified deep to the superior constrictor musculature and at the intersection of the posterior tonsillar pillar with the base of tongue. The styloglossus muscle forms the deep plane medial to the ECA. The mean measurements for left C2\u2010C3 interspace to the ECA and right C2\u2010C3 interspace to ECA were 17.6 \u00b1 0.8 mm and 18.4 \u00b1 0.8 mm, respectively. Similarly, the mean measurements for left hyoid to ECA and right hyoid to ECA were 3.4 \u00b1 0.8 mm and 4.3 \u00b1 0.6 mm, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A systematic approach to dissect the tonsillar fossa and lateral pharyngeal wall can be performed using key anatomic landmarks. CT measurements taken at the C2\u2010C3 interspace and greater horn of hyoid bone (C6 level) to the ECA are consistently and reliably achieved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA. <jats:italic>Laryngoscope<\/jats:italic>, 123:3021\u20133025, 2013<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.23927","type":"journal-article","created":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T15:12:15Z","timestamp":1381245135000},"page":"3021-3025","source":"Crossref","is-referenced-by-count":26,"title":["Transoral anatomy of the tonsillar fossa and lateral pharyngeal wall: Anatomic dissection with radiographic and clinical correlation"],"prefix":"10.1002","volume":"123","author":[{"given":"Chwee Ming","family":"Lim","sequence":"first","affiliation":[{"name":"Veterans Affaris Pittsburgh Health System Department of Otolaryngology\/Head and Neck Surgery Pittsburgh Pennsylvania U.S.A."},{"name":"Department of Otolaryngology National University of Singapore  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Mehta","sequence":"additional","affiliation":[{"name":"Veterans Affaris Pittsburgh Health System Department of Otolaryngology\/Head and Neck Surgery Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Chai","sequence":"additional","affiliation":[{"name":"Veterans Affaris Pittsburgh Health System Department of Otolaryngology\/Head and Neck Surgery Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos\u2010Neto D.","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Veterans Affaris Pittsburgh Health System Department of Otolaryngology\/Head and Neck Surgery Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Rath","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pittsburgh Medical Center, Eye and Ear Institute Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Snyderman","sequence":"additional","affiliation":[{"name":"Veterans Affaris Pittsburgh Health System Department of Otolaryngology\/Head and Neck Surgery Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umamaheswar","family":"Duvvuri","sequence":"additional","affiliation":[{"name":"Veterans Affaris Pittsburgh Health System Department of Otolaryngology\/Head and Neck Surgery Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,9,19]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"1010","article-title":"A shifting paradigm for patients with head and neck cancer: transoral robotic surgery (TORS)","volume":"24","author":"Bhayani MK","year":"2010","journal-title":"Oncology"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.24"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.40"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21750"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20647"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32832924f5"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.12.1220"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.09.024"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21845"}],"container-title":["The 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