Resection of Parapharyngeal Space Tumors Located in the Prestyloid Compartment: Efficacy of the Cervical Approach

Removal of a Giant Parapharyngeal Space Oncocytoma Without Osteotomy

Oncocytoma arising from the parotid gland and extending into the parapharyngeal space (PPS) has not been previously reported. A 64-year-old woman presented with a large slowly growing mass extending from the parotid to the submandibular area, expanding medially to displace the pharynx across the midline. Core-needle biopsy revealed an oncocytoma in the PPS measuring 120 × 88 × 60 mm in size. Although the tumor was of an unprecedentedly large size and extended into multiple spaces, it could be removed via a cervical-parotid approach without osteotomy. The resected tumor was again diagnosed as oncocytoma. A postoperative complication was weakness of the ipsilateral facial nerve, which almost completely resolved in 6 months. No recurrence has been noted on 1 y follow-up. We were able to resect an extremely large oncocytoma arising from the parotid gland without osteotomy.

Parapharyngeal space tumors: a twenty-year single-center retrospective analysis on the effectiveness of transcervical and transoral approaches on local control and disease-specific survival

INTRODUCTION

To retrospectively analyzed our twenty-years single-center experience in the treatment of PPS tumors, focusing on the selection of surgical approach and the survival outcome.

METHODS

Tumors involving the PPS between January 2000 and February 2022 were retrospectively included. The surgical approach was dictated by the localization of the tumor, its dimensions, the relation to anatomic structures and its etiology.

RESULTS

34 patients were included in the study. The median age was 50.5 yr, with a gender female prevalence. Most tumors were benign and non recurrent. 20 tumors were treated through lateral approach (transcervical or transcervical-transparotid), 11 through medial approach (transoral), and only 3 tumors were approached by multiple corridors. The 5 years disease free survival (DFS) was 78.8 % (CI 78-79.3 %).

CONCLUSIONS

In our experience, the transcervical and transoral approaches can be considered the ideal surgical approach to manage tumors of PPS, especially in cases of benign neoplasms.

Management of Parapharyngeal Space Tumors: Clinical Experience with a Large Sample and Review of the Literature

Parapharyngeal space (PPS) tumors are rare, and they account for 0.5-1.5% of all head and neck tumors. This study summarized the findings of large-sample clinical studies of PPS tumors and reported the clinical work-up and management of 177 cases of PPS tumors at our center. This retrospective study included patients treated for PPS tumors between 2005 and 2020 at our center. The basic characteristics, symptoms, surgical approach, complications, and recurrence rates were analyzed. A total of 99 male and 78 female patients, with a mean age of 48.3 ± 15.1 years, were enrolled in this study. The most common symptoms were external or intraoral masses (114 patients, 64%). Surgical management leveraging, a cervical approach, was used for 131 cases (74%). The tumors were benign for 92% (160 cases), with pleomorphic adenoma being the most common (88 cases, 50%). Surgical complications were reported for 31 cases (18%); facial and vocal cord paralyses were the most common. Three cases of recurrence were observed during the follow-up. PPS tumors are rare and present with atypical clinical manifestations. The current study, which involved cases in a large single center, demonstrates the importance of surgical interventions for PPS tumors. The use of endoscopic techniques has further expanded the scope of traditional surgical approaches and demonstrated its advantages in selected cases.

Trends in the surgical management of parapharyngeal space tumors: A single-center retrospective analysis

PURPOSE

Surgery remains the mainstay treatment for parapharyngeal space (PPS) tumors. Given the rapid advance and increasing usage of endoscopic and robotic techniques, we aimed to investigate the surgical trends of PPS tumors in our institution and analyze their impact on patients' treatment outcomes.

MATERIALS AND METHODS

All patients who underwent surgical resection of PPS tumors from 2014 to 2021 at the Eye, Ear, Nose, and Throat Hospital of Fudan University were retrospectively reviewed. Student's t-test, Chi-square test, and multinomial logistic regression analyses were used to compare the surgical outcomes between groups.

RESULT

Of the included 389 patients, the recipients of endoscopic surgery have largely increased in our center, with 17 of 134 cases (12.7%) in the group 2014-2017 and 187 of 255 cases (73.3%) in the group 2018-2021. The use of transoral and trans-nasal approaches increased in recent years (5.2% in 2014-2017 vs. 26.0% in 2018-2021), while that of trans-mandibular and lateral skull base approaches decreased (5.9% in 2014-2017 vs. 0.8% in 2018-2021). Decreased blood loss of operation and decreased risks of postoperative neurovascular complications were observed in the group 2018-2021. Similar findings were observed among patients receiving endoscopic surgery when compared with those receiving conventional surgery.

CONCLUSION

In our institution, the overall trends in the surgical management of PPS tumors moved towards minimally invasive approaches with the assistance of endoscopy or surgical robots. The two surgical techniques were feasible and safe, and to a great extent, contributed to the improved surgical outcomes we observed in recent years.

Surgical Treatment of Parapharyngeal Space Salivary Gland Tumor

INTRODUCTION

Parapharyngeal space salivary gland tumors are very rare. The authors sought to examine the clinical features, treatment methods, and treatment results of parapharyngeal space salivary gland tumors in our hospital.

METHODS

The authors retrospectively enrolled 15 patients who were finally diagnosed as having parapharyngeal space salivary gland tumors from January 2010 to January 2021.

RESULTS

All parapharyngeal space salivary gland tumors arose from the prestyloid compartment. This study included 3 males and 12 females. The main symptoms were incidental diagnosis during imaging tests, followed by neck discomfort, oral mass, neck mass, and headache. Surgical methods for parapharyngeal space salivary gland tumors were performed in the following order: transcervical approach (n = 10), transcervical-parotid approach (n = 3), transoral approach (n = 1), and transparotid approach (n = 1). Pleomorphic adenoma was the most common tumor among parapharyngeal space salivary gland tumors.

CONCLUSIONS

In the surgery of parapharyngeal space salivary gland tumors, a transcervical or transcervical-parotid approach was mainly used by predicting the origin site through radiologic examinations.