Transoral Excision of Parapharyngeal Tumors

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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A comparative study of the endoscopy-assisted transoral approach versus external approaches for the resection of large benign parapharyngeal space tumors

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2016.09.010 ◽

2017 ◽

Vol 123 (2) ◽

pp. 157-162 ◽

Cited By ~ 6

Author(s):

Song Fan ◽

Shi-geng Lin ◽

Han-qing Zhang ◽

Qun-xing Li ◽

Wei-xiong Chen ◽

...

Keyword(s):

Comparative Study ◽

Parapharyngeal Space ◽

Transoral Approach ◽

Parapharyngeal Space Tumors

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A comparative study of parapharyngeal space tumors over a 7 year period experience in tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182958 ◽

2018 ◽

Vol 4 (5) ◽

pp. 1167

Author(s):

Athiyaman K. ◽

Gowri Shankar M. ◽

Suresh V. ◽

Natarajan S. ◽

Malarvizhi R.

Keyword(s):

Parapharyngeal Space ◽

Malignant Tumors ◽

Tertiary Care ◽

Direct Access ◽

Vascular Lesions ◽

Care Hospital ◽

Neurogenic Tumors ◽

Parapharyngeal Space Tumors ◽

First Choice ◽

Cervical Approach

Background: Tumors of the parapharyngeal space (PPS) are rare, accounting for 0.5–1.5% of all head and neck tumors. The anatomy of the PPS is responsible for a wide variety of tumors arising from the PPS. Our series of 10 PPS tumors provides an overview of the clinical course and management of PPS tumors.Methods: This retrospective study included clinical data from patients treated for PPS tumors from 2011 to 2018 at the Stanley medical college hospital, Chennai. Results: After careful analysis of the outcome of the study, we have found out that there was no local recurrence in any patient during the follow-up period. Though few approaches are advised in the literature, In our study transoral approach may be advocated as the first choice for excision of parapharyngeal space tumors, except for malignant tumors and neurogenic tumor. Trans cervical approach is used for malignant and neurogenic tumors, considering its advantages of providing direct access to the neoplasm, adequate control of neurovascular structures from the neck.Conclusions: In our study, middle aged male population was most commonly affected. Pleomorphic adenoma is the most common PPS tumor; prestyloid compartment is mostly affected by these tumors. As per the previous studies, trans cervical approach is first choice for excision of parapharyngeal space tumors. In our study, trans oral approach is also a suitable, safe approach for pre styloid non vascular lesions and trancervical approach can be reserved for postsyloid and malignant lesions.

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Neuroendocrine tumor of parapharyngeal space

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v43i1.15 ◽

2013 ◽

Vol 43 (1) ◽

Author(s):

Marlinda Adham ◽

Novra Widayanti

Keyword(s):

Neuroendocrine Tumor ◽

Head And Neck ◽

Clinical Case ◽

Parapharyngeal Space ◽

Good Prognosis ◽

Salivary Gland Neoplasm ◽

Parapharyngeal Space Tumors ◽

Neck Tumors ◽

Extreme Risk ◽

Parapharyngeal Tumor

Background: Parapharyngeal space tumors account for some 0.5% of tumors of the head and neck, most ofthem benign. The most common benign neoplasms are salivary gland neoplasm, paragangliomas and followed byneurogenic tumors. The importance of these tumors lies mainly in two aspects, the difficulty of early diagnosis,due to the lack of symptoms in the initial stages and, on the other hand, the extreme risk of complications inperforming surgery in the parapharyngeal region. Purpose: We present this case to enlighten generalpractitioners and also otorhinolaryngologist about diagnosis and management of parapharyngeal tumor. Case:One clinical case of neuroendocrine tumor in parapharyngeal space on a 37 years old man. Management: Thepatient underwent diagnosis procedure and extirpation of the tumor mass. Conclusion: Parapharyngeal tumor isone of head and neck tumors that has good prognosis, especially if diagnosed early and adequately treated.Keywords: neuroendocrine tumor, parapharyngeal space, benign tumor.ABSTRAKLatar belakang: Tumor parafaring meliputi sekitar 0,5% dari seluruh tumor kepala dan leher, sebagianbesar jinak. Tumor jinak yang paling sering adalah tumor kelenjar liur, paraganglioma dan tumor neurogenik.Tumor parafaring ini penting disebabkan sulit untuk melakukan diagnosis dini karena sedikitnya gejala padatahap awal dan kemungkinan komplikasi yang dapat terjadi pada saat dilakukan tindakan bedah di daerahparafaring. Tujuan: Kasus ini diajukan agar para dokter umum dan spesialis Telinga Hidung Tenggorok dapatmengenali diagnosis dan penatalaksanaan tumor parafaring. Kasus: Dilaporkan satu kasus tumorneuroendokrin parafaring pada laki-laki usia 37 tahun. Penatalaksanaan: Pada pasien ini dilakukan proseduruntuk mendiagnosis tumor dan dilakukan ekstirpasi massa tumor. Kesimpulan: Tumor parafaring merupakansalah satu dari tumor kepala dan leher yang mempunyai prognosis baik terutama bila didiagnosis secara dinidan diterapi secara adekuat.Kata kunci: Tumor neuroendokrin, spatium parafaring, tumor jinak.

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Endoscope-assisted transoral approach to parapharyngeal space tumors

Head & Neck ◽

10.1002/hed.23592 ◽

2014 ◽

Vol 37 (2) ◽

pp. 243-248 ◽

Cited By ~ 20

Author(s):

Mete Iseri ◽

Murat Ozturk ◽

Ahmet Kara ◽

Selcuk Ucar ◽

Omer Aydin ◽

...

Keyword(s):

Parapharyngeal Space ◽

Transoral Approach ◽

Parapharyngeal Space Tumors

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Endoscopic transoral approach for resection of retrostyloid parapharyngeal space tumors: Retrospective analysis of 16 patients

Head & Neck ◽

10.1002/hed.26415 ◽

2020 ◽

Vol 42 (12) ◽

pp. 3531-3537

Author(s):

Lifeng Li ◽

Nyall R. London ◽

Yanyong Gao ◽

Ricardo L. Carrau ◽

Xiaohong Chen

Keyword(s):

Retrospective Analysis ◽

Parapharyngeal Space ◽

Transoral Approach ◽

Parapharyngeal Space Tumors

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

The Laryngoscope ◽

10.1002/lary.29458 ◽

2021 ◽

Author(s):

Huihong Chen ◽

Zhiying He ◽

Guo Li ◽

Chao Liu ◽

Diekuo Zhang ◽

...

Keyword(s):

Systematic Review ◽

Parapharyngeal Space ◽

Meta Analysis ◽

Transoral Approach ◽

Parapharyngeal Space Tumors

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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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