Endoscopy‐Assisted Transoral Approach to Resect Parapharyngeal Space Tumors: A Systematic Review and Meta‐Analysis

Objectives: The transoral approach for parapharyngeal space tumors has been criticized due to its restrictive exposure and increased rate of vascular and nerve injuries. However, for certain tumors—namely those that are prestyloid, benign, and well-encapsulated—the transoral approach reduces overall morbidity while providing direct access. Transoral surgeons can rely on this approach for select tumors seen clearly on intraoral examination in the bulging lateral pharynx. In this article and with a supplemental operative technique video, we demonstrate our transoral approach in these select patients. Methods: We reviewed our 26 cases using this approach and chose a representative case of a 50-year-old man who presented with a large, prestyloid, encapsulated parapharyngeal mass affecting his voice and swallowing. A transoral approach to the parapharyngeal tumor is illustrated. Results: A vertical curvilinear incision is completed from the hamulus to below the inferior extent of the tumor. Blunt dissection of the tumor capsule proceeds inferiorly. Controlled violation of the tumor capsule can aid in visualization. After tumor delivery, the wound is irrigated and closed. Conclusions: In our experience, the transoral approach is an effective method to access well-encapsulated, prestyloid parapharyngeal space tumors. Patient selection is important when considering a transoral approach.

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Endoscopic Transnasal Combined Transoral Approach for Giant Parapharyngeal Space Tumors

10.1055/s-0040-1702637 ◽

2020 ◽

Author(s):

Xicai Sun ◽

Huan Wang ◽

Quan Liu ◽

Weidong Zhao ◽

Yurong Gu ◽

...

Keyword(s):

Parapharyngeal Space ◽

Transoral Approach ◽

Parapharyngeal Space Tumors

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Surgical approach to parapharyngeal space tumors

Acta chirurgica iugoslavica ◽

10.2298/aci1104061d ◽

2011 ◽

Vol 58 (4) ◽

pp. 61-66 ◽

Cited By ~ 1

Author(s):

Milovan Dimitrijevic ◽

Snezana Jesic ◽

Aleksandar Krstic ◽

Goran Bjelogrlic ◽

Goran Stojkovic

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Computerized Tomography ◽

Surgical Approach ◽

Parapharyngeal Space ◽

Transoral Approach ◽

Diagnostic Methods ◽

Resonance Imaging ◽

Parapharyngeal Space Tumors ◽

Adjacent Structures

Introduction: Parapharyngeal space tumors are very rare comprising 0,5% of head and neck tumors. Tumors of this region are significant diagnostic problem due to scanty symptomatology as well as considerable surgical issue owing to inaccessibility. Patients and Methods: Retrospective twenty-year study of patients with parapharyngeal space tumors included 69 patients. Data were obtained from medical records, and were pointed to diagnostic procedures, surgical approach and pathohistological findings. Symptoms and clinical signs were also investigated. Results: Preoperative diagnostics is very important for precise tumor localization and relation to adjacent structures. Computerized tomography was the most common method used, and recently, magnetic resonance imaging and indication-based contrast angiography have been applied. All of 69 patients with parapharyngeal space tumors were treated surgically. The most often approach to this tumor was transcervical (62%), then transoral approach and combination transcervical transoral approach. Pathohistological examination verified that most of the tumors were benign (75%) and origin of these tumors was most frequently salivary (42%). Conclusion: For making a decision on surgical approach, diagnostic methods, other than thorough examination, such as computerized tomography(CT) and/or magnetic resonance imaging (MR), are necessary to be applied.

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