{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:52:25Z","timestamp":1777877545992,"version":"3.51.4"},"reference-count":74,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>There are few studies comparing the various surgical approaches for the resection of parapharyngeal space tumors (PPSTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare surgical outcomes between transoral approaches (conventional transoral approach, endoscopic-assisted transoral approach, and transoral robotic surgery) and external approaches (EAs) in treating PPSTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review with meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Embase, MEDLINE, CINAHL, Cochrane, and Web of Science databases were searched until August 2024. Findings were reported as per the PRISMA guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adult patients with PPST.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Surgical tumor resection using external or transoral approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Overall effect size for primary outcomes (overall, neurological, non-neurological postoperative complications, and recurrence rates) was presented as event rate, while secondary outcomes (intraoperative bleeding, operation time, and hospitalization duration) were presented as mean differences (MDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-eight studies involving 1728 patients with PPST were included. EAs were associated with higher incidences of overall [0.40 (0.32-0.48) vs 0.11 (0.08-0.15)] and neurological [0.30 (0.22-0.38) vs 0.05 (0.03-0.07);\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001] postoperative complications than transoral approaches (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001 for both) with no significant difference in non-neurological complications. In addition, transoral approaches were associated with significantly fewer postoperative complications than EAs for benign [0.12 (0.22-0.35) vs 0.39 (0.29-0.48);\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001], malignant [0.17 (\u22120.08- 0.41) vs 0.63 (0.30-0.95);\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.03], and prestyloid [0.11 (0.06-0.17) vs 0.39 (0.22-0.05);\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001] but not poststyloid tumors. Furthermore, transoral approaches were associated with significantly lower intraoperative blood loss (MD: \u2212104.30\u2009mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.00001) and shorter hospitalization (MD: \u22121.70\u2009days;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002) compared to EAs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Transoral surgical approaches may be safe and feasible surgical treatments for selected patients, particularly in the prestyloid compartment, when performed in centers with expertise in advanced transoral surgery. Compared to EAs, these approaches had fewer postoperative neurological complications, less intraoperative bleeding, and shorter hospitalization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251414008","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T07:30:29Z","timestamp":1770449429000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes with Transoral and External Surgical Approaches for Resection of Parapharyngeal Space Tumors: Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5476-1815","authenticated-orcid":false,"given":"Arshbir","family":"Aulakh","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mankirat","family":"Gillon","sequence":"additional","affiliation":[{"name":"Faculty of Science, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3862-4404","authenticated-orcid":false,"given":"Brendan D.","family":"McNeely","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Head &amp; Neck Surgery, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron","family":"Bakala","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Head &amp; Neck Surgery, University of British Columbia, Kelowna, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciaran","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada"},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, The University of Ottawa, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2007.10.012"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2014.02.007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25077"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30010078"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-021-06718-4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-4891-x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2010.01.003"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25378"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2021.03.001"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0145561318097004-501"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2018.01.008"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.104581"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29458"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1744164"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9491-z"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1258\/1355819021927674"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.22038\/ijorl.2019.38350.2268"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1017\/S002221512200175X"},{"issue":"5","key":"e_1_3_2_21_2","first-page":"310","article-title":"Parapharyngeal space tumours: the efficiency of a transcervical approach without mandibulotomy through review of 44 cases","volume":"34","author":"Basaran B","year":"2014","unstructured":"Basaran B, Polat B, Unsaler S, Ulusan M, Aslan I, Hafiz G. 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