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Surgical approaches for pleomorphic adenoma of the parapharyngeal space. J Laryngol Otol 2022:1-8. [PMID: 35920024 DOI: 10.1017/s002221512200175x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE This study aimed to analyse the outcomes of surgery for pleomorphic adenoma of the parapharyngeal space in relation to the surgical approach. METHOD This was a single-centre retrospective data analysis conducted from January 2008 to December 2020 on all patients who underwent operation for pleomorphic adenoma originating from the parapharyngeal space. RESULTS Twenty-one patients with a mean age of 52.6 years were included. The transparotid-transcervical approach was the most common (52.4 per cent, n = 11) surgical approach, followed by transoral robotic surgery (28.6 per cent, n = 6) and conventional transoral surgery (19 per cent, n = 4). Post-operative complications included nine cases of transient partial facial nerve palsy and two cases of Frey's syndrome after the transparotid-transcervical approach and 2 cases of transient trismus and 1 pharyngeal wound dehiscence in the conventional transoral approach group. Complete macroscopic excision was always achieved, and no recurrence occurred during follow up. CONCLUSION These three approaches can provide adequate tumour visualisation, a high rate of clear excisional margins and an acceptable morbidity.
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Suárez C, López F, Rodrigo JP, Mendenhall WM, de Bree R, Mäkitie AA, Vander Poorten V, Takes RP, Bondi S, Kowalski LP, Shaha AR, Fernández-Alvarez V, Gutiérrez JC, Zidar N, Chiesa-Estomba C, Strojan P, Sanabria A, Rinaldo A, Ferlito A. Benign Peripheral Non-cranial Nerve Sheath Tumors of the Neck. Adv Ther 2022; 39:3449-3471. [PMID: 35689724 DOI: 10.1007/s12325-022-02191-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
Abstract
Benign peripheral non-cranial nerve sheath tumors are rare lesions, including both schwannomas and neurofibromas. These tumors arise from Schwann cells, and may originate from any peripheral, cranial, or autonomic nerve. Most of them are localized and sporadic but multifocal systemic forms can occur. Cervical sympathetic chain, brachial plexus, cervical plexus and spinal roots and nerves are the major nerve systems commonly affected. Dumbbell-shaped intra- and extradural tumors occur most commonly in the cervical spine, as well as purely extradural and paravertebral tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques and surgical innovations such as endoscopically assisted approaches and robotic surgery. Microsurgical intracapsular excision of the tumor helped by the use of intraoperative fluorescent dyes and intraoperative neurophysiological monitoring minimize postoperative neural deficit, since most schwannomas are encapsulated. Most tumors can be removed with a low rate of complications and recurrence. Radiotherapy should be considered for growing lesions that are not amenable to surgery. In asymptomatic patients, observation and serial scans is an option for elderly infirm patients.
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Affiliation(s)
- Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias, Avenida de Roma s/n, 33011, Oviedo, Spain.
| | - Fernando López
- Instituto de Investigación Sanitaria del Principado de Asturias, Avenida de Roma s/n, 33011, Oviedo, Spain.
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, Avenida de Roma s/n, 33011, Oviedo, Spain.
| | - Juan P Rodrigo
- Instituto de Investigación Sanitaria del Principado de Asturias, Avenida de Roma s/n, 33011, Oviedo, Spain
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, Avenida de Roma s/n, 33011, Oviedo, Spain
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Vincent Vander Poorten
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
- Otorhinolaryngology, Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stefano Bondi
- Head and Neck Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy
| | - Luiz P Kowalski
- Head and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center and University of São Paulo Medical School, São Paulo, Brazil
| | - Ashok R Shaha
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Julio C Gutiérrez
- Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Nina Zidar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Carlos Chiesa-Estomba
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, San Sebastián, Spain
| | - Primoz Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia/Hospital Universitario San Vicente Fundación, 050010, Medellín, Colombia
- CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, 050021, Medellín, Colombia
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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