scholarly journals Endoscopy-Aided Combined Intraoral and Cervical Approach for a Huge Parapharyngeal Benign Tumor

2020 ◽  
pp. 014556132093583
Author(s):  
Atsunobu Tsunoda ◽  
Seiji Kishimoto ◽  
Miri Tou ◽  
Takashi Anzai ◽  
Fumihiko Matsumoto ◽  
...  
Keyword(s):  
Benign Tumor ◽  
Parapharyngeal Space ◽  
Benign Lesion ◽  
Skin Incision ◽  
Surrounding Tissue ◽  
Endoscopic Observation ◽  
Facial Wound ◽  
Cervical Approach ◽  
Surgical Field ◽  
Parapharyngeal Tumor

We introduce here our surgical approach for the removal of a huge parapharyngeal tumor in 3 cases. Surgery was done under general anesthesia using transnasal intubation. Transoral manipulation was performed first. Using a tongue retractor and an angle widener, a wide surgical field was provided. Incision was made on the palate around the tumor. Tumor was separated from the surrounding tissue, preserving the tumor capsule. Then, a 5-cm small skin incision was made. Both parotid and submandibular glands were pushed upward, and the parapharyngeal space was opened. The tumor was also separated from the surrounding tissue. These manipulations were done under endoscopic observation. Finally, the tumor was pushed laterally and safely removed intraorally. After removal of the tumor, the wounds were closed, and vacuum drainage was settled for a few days. No apparent problems, such as malocclusion and facial palsy, occurred, and the patients were free from disease for more than 10 years. For the removal of a large parapharyngeal tumor, the mandibular swing approach is usually used; however, this approach is invasive, and certain sequelae, such as facial wound and malocclusion, may occur. Our technique enables the safe and less invasive removal of such a huge parapharyngeal benign lesion.

scholarly journals Instruments Used in Skin Incision

2018 ◽  
Vol 2 (3) ◽  
pp. 557-561
Author(s):  
Bárbara Cartes ◽  
Leonardo Brito ◽  
Juan Alister ◽  
Francisca Uribe ◽  
Sergio Olate
Keyword(s):  
Postoperative Infection ◽  
Surgical Intervention ◽  
Skin Incision ◽  
Repair Time ◽  
Surrounding Tissue ◽  
Cosmetic Results ◽  
Conventional Instrumentation

The incision is the beginning of every surgical intervention, where separation of the tissues occurs. The uses of thermal mechanisms in skin incisions have been controversial due to higher repair time, necrosis of surrounding tissue, postoperative infection, and poor cosmetic results. The purpose of this study was to determine the evolution of the various types cutting systems and compare the tissue’s response on the use of conventional instrumentation versus diathermy

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

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

<p class="abstract"><strong>Background:</strong> Tumors of the parapharyngeal space (PPS) are rare, accounting for 0.5–1.5% of all head and neck tumors. The<strong> </strong>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.</p><p class="abstract"><strong>Methods:</strong> This retrospective study included clinical data from patients treated for PPS tumors from 2011 to<strong> </strong>2018 at the Stanley medical college hospital, Chennai.  </p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals Spindle Cell Lipoma of the Parapharyngeal Space: First Report of a Case

2001 ◽  
Vol 80 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Ingo Baumann ◽  
Florian Dammann ◽  
Hans Peter Horny ◽  
Peter Karl Plinkert
Keyword(s):  
Spindle Cell ◽  
Parapharyngeal Space ◽  
Subcutaneous Tissue ◽  
Resonance Imaging ◽  
Spindle Cell Lipoma ◽  
Lipomatous Tumor ◽  
Pharyngeal Muscles ◽  
Parapharyngeal Tumor ◽  
The Right ◽  
Total Parotidectomy

Spindle cell lipomas are usually located in the subcutaneous tissue of the back, shoulders, and neck. To our knowledge, the presence of such a tumor in the parapharyngeal space has not yet been described. We evaluated a 45-year-old man with a tender swelling of the right parotid area that had reached the submandibular area. Clinical examination and magnetic resonance imaging revealed the presence of a tumor that coated the parotid area laterally and extended into the center of the parapharyngeal space, thus causing a dislocation of the pharyngeal muscles and mucosa. We performed a total parotidectomy and submandibulectomy on the right side and extirpated the parapharyngeal tumor. We were able to spare the facial nerve, and no facial paralysis occurred. Histologic examination revealed an atypical lipomatous tumor with a remarkably large portion of spindles.

Malignant transformation of the salivary gland pleomorphic adenoma in myoepithelial carcinoma – the report of two cases

2019 ◽  
Vol 8 (1) ◽  
pp. 52-55
Author(s):  
Paulina Szabelska ◽  
Anna Rzepakowska ◽  
Benedykt Szczepankiewicz ◽  
Elżbieta Niemczyk ◽  
Ewa Osuch-Wójcikiewicz ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Surgical Treatment ◽  
Salivary Glands ◽  
Pleomorphic Adenoma ◽  
Malignant Transformation ◽  
Benign Tumor ◽  
Complete Recovery ◽  
Surrounding Tissue ◽  
Carcinoma Ex Pleomorphic Adenoma ◽  
Myoepithelial Carcinoma

A multiform adenoma is the most commonly diagnosed benign tumor of the salivary glands. In the majority of patients, surgical resection of the tumor with the adequate surrounding tissue of salivary gland allows for complete recovery. A small percentage of the cases is a recurring pleomorphic adenoma. Even more rarely the diagnosis of carcinoma ex pleomorphic adenoma is made. The study presents two clinical cases of the malignant transformation of pleomorphic adenoma into the myoepithelial carcinoma. The surgical treatment and additional radiotherapy were performed in both cases.

scholarly journals Neuroendocrine tumor of parapharyngeal space

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.

scholarly journals Rhabdomyoma of the parapharyngeal space

2021 ◽  
Vol 106 (106(813)) ◽  
pp. 215-217
Author(s):  
C. Acosta-Vásquez ◽  
L. Uceda-Carrascosa ◽  
F. Leiva-Cepas ◽  
L. Rodríguez-Pérez
Keyword(s):  
Head And Neck ◽  
Clinical Case ◽  
Benign Tumor ◽  
Parapharyngeal Space ◽  
Asymptomatic Patient ◽  
Histological Study ◽  
Mesenchymal Tumor ◽  
Skeletal Tissue ◽  
Rare Benign Tumor ◽  
Ct And Mri

Rhabdomyoma is a benign tumor that comes from skeletal tissue, it is classified as cardiac and extracardiac according to the location. Extracardiac rhabdomyomas most frequently originate in the head and neck at the larynx and pharynx, being the parapharyngeal space an exceptional location. We present the clinical case of an 86-year-old man asymptomatic patient with a laterocervical mass with years of evolution, that has increased its size progressively, with dysphagia and dyspnea on exertion in the last years. CT and MRI were requested, which provided dimensions, location at the parapharyngeal space, as well as signs of benignity. The FNA results indicated that it was a mesenchymal tumor. After cervicotomy and histological study, the diagnosis of parapharyngeal space rhabdomyoma was confirmed. We conducted a bibliographic review of this extremely rare benign tumor at the head and neck level.

Parapharyngeal Ganglioneuroma with Neurofibromatosis: An Unusual Presentation

2011 ◽  
Vol 120 (12) ◽  
pp. 769-774 ◽  
Author(s):  
Parul Sinha ◽  
Suresh C. Sharma ◽  
Shipra Agarwal ◽  
Siddhartha Datta Gupta
Keyword(s):  
Unusual Case ◽  
Benign Tumor ◽  
Parapharyngeal Space ◽  
Treatment Approach ◽  
Hypertensive Crisis ◽  
Neurogenic Tumors ◽  
Appropriate Treatment ◽  
Rare Benign Tumor ◽  
Hypertensive Crises ◽  
Biochemical Features

Objectives: Ganglioneuroma is a rare benign tumor of the sympathetic nervous system that is seldom localized to the head and neck. Rarer still are cases of functional ganglioneuroma with catecholamine production. We report an unusual case of a large parapharyngeal space ganglioneuroma in a patient with neurofibromatosis that caused an intraoperative hypertensive crisis in the absence of a neuroblastomatous component — Hitherto an undocumented complication. Methods: We present a case of functional parapharyngeal ganglioneuroma and review the clinicopathologic and biochemical features of these rare tumors. Results: Fewer than 40 anecdotal cases of parapharyngeal ganglioneuromas have been reported, and there is a lack of ade quate literature on the biology and appropriate treatment approach of these tumors. Conclusions: Our case illustrates the importance of vigilant preoperative precautions in the management of neurogenic tumors, particularly ganglioneuromas. These usually nonfunctional tumors can result in sudden intraoperative and postoperative hypertensive crises even in the absence of any preoperative autonomic symptoms.

Comparison of Ankle Joint Visualization Between the 70° and 30° Arthroscopes: A Cadaveric Study

2017 ◽  
Vol 11 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Ichiro Tonogai ◽  
Fumio Hayashi ◽  
Yoshihiro Tsuruo ◽  
Koichi Sairyo
Keyword(s):  
Ankle Joint ◽  
Distal Tibia ◽  
Skin Incision ◽  
Surrounding Tissue ◽  
Osteochondral Lesions ◽  
Talar Dome ◽  
Kirschner Wires ◽  
Anterior Edge ◽  
Ankle Surgery ◽  
Anterior Ankle Impingement

Ankle arthroscopy is an important diagnostic and therapeutic tool. Arthroscopic ankle surgery for anterior ankle impingement or osteochondral lesions (OCLs) is mostly performed with a 30° arthroscope; however, visualization of lesions is sometimes difficult. This study sought to compare ankle joint visualization between 70° and 30° arthroscopes and clarify the effectiveness of 70° arthroscopy. Standard anterolateral and anteromedial portals were placed with 4-mm 70° or 30° angled arthroscopes in a fresh 77-year-old male cadaveric ankle. The medial ligament and surrounding tissue were dissected via a medial malleolar skin incision. Kirschner wires were inserted into the distal tibia anterior edge; 5-mm diameter OCLs were created on the medial talar gutter anteriorly, midway, and posteriorly. The talar dome and distal tibia anterior edge were visualized using both arthroscopes. The 70° arthroscope displayed the anterior edge of the distal tibia immediately in front of the arthroscope, allowing full visualization of the posterior OCL of the medial talar gutter more clearly than the 30° arthroscope. This study revealed better ankle joint visualization with the 70° arthroscope, and may enable accurate, safe, and complete debridement, especially in treatment of medial talar gutter posterior OCLs and removal of anterior distal tibial edge bony impediments. Levels of evidence: Level IV, Anatomic study

scholarly journals A Case of Calcified Metastatic Colorectal Adenocarcinoma Mimicking a Benign Lesion: Pitfalls in Diagnosis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Peter Michail ◽  
Iftah Amith ◽  
Sanila George ◽  
Mathew K. George
Keyword(s):  
Brain Metastases ◽  
Colorectal Adenocarcinoma ◽  
Benign Lesion ◽  
Brain Lesion ◽  
Radiological Finding ◽  
Surrounding Tissue ◽  
Calcified Lesion ◽  
High Index Of Suspicion ◽  
Slow Growing ◽  
Benign Mass

The radiological finding of a calcified intracranial lesion commonly represents a slow growing benign mass. Brain metastases originating from colorectal cancers are rare, occurring in approximately 2-3% of patients. Therefore the presence of a calcified brain lesion in a patient with a positive oncological history requires a high index of suspicion for brain metastases. Presented herein is a case of a frontoparietal calcified lesion initially overlooked as a benign tumour. Subsequent imaging following a neurological episode revealed a significant increase in size of the lesion with surrounding tissue oedema, prompting further investigation for suspicion of a calcified metastatic colorectal adenocarcinoma.

scholarly journals Schwanoma of tonsil

2020 ◽  
Vol 46 (2) ◽  
pp. 142-144
Author(s):  
Pran Gopal Datta ◽  
Nasima Akhtar ◽  
Abirvab Naha ◽  
Anindita Datta
Keyword(s):  
Head And Neck ◽  
Parapharyngeal Space ◽  
Benign Lesion ◽  
Neck Region ◽  
Vital Role ◽  
Nerve Fibers ◽  
Radiological Assessment ◽  
Myelinated Nerve ◽  
Head And Neck Region ◽  
Myelinated Nerve Fibers

Background: Schwannoma is mostly benign lesion that originates from the Schwannoma cells that cover the myelinated nerve fibers. Schwannoma arising from the tonsil are very rare. In head and neck region the incidence rate of schwannoma is between 25 to 45%. In most of the cases vestibular nerve followed by a parapharyngeal space is involved. It is also known as neurilemmoma. Objective: To diagnoses and manage the case of a Schwannoma of Tonsil. Findings: A case of tonsillar schwannoma in a 42 years old males was reported. The patient presented with unilateral enlargement of left tonsil with congested pharyngeal mucosa. Conclusion: Proper clinical examination with radiological assessment plays a vital role to diagnosis this accurately. Bangladesh Med Res Counc Bull 2020; 46(2): 142-144

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