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        <datestamp>2026-09-21T04:28:41Z</datestamp>
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          <dc:title>Video 1_Patient-specific three-dimensional planning for surgical approach selection in parapharyngeal space lesions: development of the Vall d’Hebron 3D-PPS Algorithm.mp4</dc:title>
          <dc:creator>Pablo Vergés Fort (25079866)</dc:creator>
          <dc:creator>Juan Fernando Fuentes Cabrera (25079869)</dc:creator>
          <dc:creator>Sílvia Naches Solsona (25079872)</dc:creator>
          <dc:creator>Laura Grau deDiego (25079875)</dc:creator>
          <dc:creator>Laura Escot Garcia (25079878)</dc:creator>
          <dc:creator>Juan Carlos Tortajada Bustelo (25079881)</dc:creator>
          <dc:creator>Jose Miguel Rodríguez Sánchez (25079884)</dc:creator>
          <dc:creator>David Virós Porcuna (25079887)</dc:creator>
          <dc:subject>Oncology and Carcinogenesis not elsewhere classified</dc:subject>
          <dc:subject>3D planning</dc:subject>
          <dc:subject>head and neck surgery</dc:subject>
          <dc:subject>parapharyngeal space (PPS)</dc:subject>
          <dc:subject>parapharyngeal tumor</dc:subject>
          <dc:subject>salivary gland tumours</dc:subject>
          <dc:subject>transoral robotic surgery (TORS)</dc:subject>
          <dc:subject>transoral robot assisted surgery</dc:subject>
          <dc:subject>virtual surgical planning</dc:subject>
          <dc:description>Introduction&lt;p&gt;Surgical management of parapharyngeal space (PPS) lesions remains challenging because of their deep anatomical location and close relationship to major neurovascular structures. Although patient-specific three-dimensional (3D) reconstruction improves anatomical visualisation, standardised methods for incorporating this information into surgical approach selection remain poorly defined. We developed the Vall d’Hebron 3D-PPS Workflow and Algorithm to integrate patient-specific anatomy into preoperative decision-making.&lt;/p&gt;Methods&lt;p&gt;Prospective observational study including 17 consecutive patients with PPS lesions treated at a tertiary referral centre. All patients underwent patient-specific 3D virtual planning integrating CT and MRI datasets. The primary outcome was the impact of the Vall d’Hebron 3D-PPS Workflow on surgical approach selection. Secondary outcomes included postoperative complications, surgical margins or completeness of lesion resection, length of hospital stay and surgeon-reported usefulness of the 3D models.&lt;/p&gt;Results&lt;p&gt;Surgical treatment consisted of transoral robotic surgery (TORS) in seven patients (41.2%), transcervical surgery in four (23.5%), combined external plus TORS in four (23.5%) and transcervical–transparotid surgery in two (11.8%). Patient-specific 3D planning modified the initially planned surgical approach in four patients (23.5%). Surgeons rated the models as very useful (Likert 5) in 76.5% of cases and useful (Likert 4) in the remaining 23.5%. Complete lesion resection or negative surgical margins were achieved in 82.4% of patients. Postoperative complications occurred in two patients (11.7%), and no mortality was observed.&lt;/p&gt;Conclusion&lt;p&gt;The Vall d’Hebron 3D-PPS Workflow complements conventional imaging by integrating patient-specific anatomy into a structured preoperative decision-making process for surgical approach selection in PPS lesions.&lt;/p&gt;</dc:description>
          <dc:date>2026-09-21T04:28:41Z</dc:date>
          <dc:type>Dataset</dc:type>
          <dc:type>Media</dc:type>
          <dc:identifier>10.3389/fonc.2026.1954820.s001</dc:identifier>
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          <dc:rights>CC BY 4.0</dc:rights>
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