Endoscopic Assisted Transoral Approach for Maxillofacial Tumor Resection-A Retrospective Study.

Abstract

Surgical resection of maxillofacial tumors requires balancing radical resection with functional and esthetic preservation. Endoscopic-assisted and transoral techniques offer minimally invasive alternatives, but each has limitations. This retrospective study evaluates the endoscopic-assisted transoral approach (EATA) for maxillofacial tumor resection, analyzing its technical characteristics, perioperative outcomes, and safety. Patients who underwent tumor resection via EATA at West China Hospital of Stomatology, Sichuan University, between April 2024 and September 2025 were included. They were stratified by tumor anatomical location and pathology. Clinical characteristics, tumor features, operative parameters, postoperative complications, and follow-up findings were collected and analyzed. A total of 32 patients with a median age of 42.5 years (range, 8-74 years) were included. Tumor distribution was as follows: accessory parotid gland (n = 15), zygomatic/buccal region (n = 9), mandibular functional area (n = 3), infratemporal fossa (n = 3), and parapharyngeal space (n = 2). The median operative time was 50 min (range, 14-304 min), and the median intraoperative blood loss was 10 mL (range, 5-150 mL). Among cases completed via EATA without conversion, no visible external scars were produced, and endoscopic magnification facilitated identification and preservation of critical neurovascular structures. One case with an intraoperative frozen-section diagnosis of mucoepidermoid carcinoma was converted to conventional parotidectomy. EATA appears to be a feasible minimally invasive option for carefully selected maxillofacial tumors in deep or esthetically sensitive anatomical regions. Its application requires strict patient selection, anatomical risk control, and adherence to oncologic principles.