Objective To evaluate the safety, efficacy, and long-term outcomes of transoral robotic surgery (TORS) for the resection of parapharyngeal space tumors (PPST).

Methods A retrospective analysis was conducted on clinical data from 16 patients who underwent TORS for PPST resection. Surgical outcomes, postoperative pathological findings, and complication rates were observed. Follow-up evaluations were performed to assess patient satisfaction, swallowing function recovery, and tumor recurrence.

Results Except for one patient who required an additional neck incision, the remaining 15 patients successfully completed the surgery via the oral route. None of the patients underwent tracheotomy or mandibulotomy. The mean surgical duration was 43.9 minutes, with an average tumor diameter of 4.5 cm resected. The mean intraoperative blood loss was 35.3 mL. Patients resumed oral intake after an average of 3.8 days and had a mean postoperative hospital stay of 8.3 days.Postoperative pathological examination revealed that the most common tumor type was pleomorphic adenoma (56.2%, 9/16), followed by schwannoma (25.0%, 4/16), with one case of basal cell adenoma, cyst, and lipoma, respectively. One patient experienced transient Horner's syndrome, two had wound dehiscence that healed spontaneously, and one had spontaneous wound healing after drainage tube dislodgement. With a mean follow-up of 79.5 months, no tumor recurrence or severe complications were observed. All patients had good swallowing function and were satisfied with the surgical outcomes.

Conclusion TORS for PPST resection offers advantages such as clear surgical visualization, direct surgical access, minimal blood loss, reduced trauma, favorable cosmetic results, and rapid postoperative recovery. It also demonstrates good long-term outcomes, with high safety and efficacy.