Combined transoral and endoscopic marsupialization for a parapharyngeal space cyst

Abstract Branchial cleft cysts in the parapharyngeal space are rare. Various surgical approaches into the parapharygeal space have been reported. Due to its difficult access and close proximity to blood vessels and cranial nerves, any surgical complication would adversely affect the quality of life or could be life-threatening. Surgeons need to be mindful of their operating skills and limitations while undertaking a surgical procedure. Here, we describe the case of a young woman who suffered from repeated infection of a parapharyngeal branchial cleft cyst. She eventually underwent a combined transoral and endoscopic marsupialization surgery uneventfully and infection control was obtained. Therefore, this surgical technique could be an alternative approach for the extirpation of parapharyngeal cysts. It ensures the clearance of infection, minimizes complications, and requires no incisions on the neck. In addition, the endoscopic component of this approach aids visualization and confirmation of the diagnosis prior to the definitive surgery.