Background Head and Neck Parapharyngeal space tumors are rare. Pleomorphic Adenomas are the most common Parapharyngeal space tumors. The purpose of this study was to define preoperative criteria for enabling full extirpation of parapharyngeal space pleomorphic adenomas via the transcervical approach while minimizing functional and cosmetic morbidity. Methods The surgical records and medical charts of 19 females and 10 males with parapharyngeal space pleomorphic adenomas operated between 1993 and 2012 were reviewed. Results Fifteen patients were operated by a simple transcervical approach, 13 by a transparotid transcervical approach, and one by a transmandibular transcervical approach. Complications included facial nerve paralysis, infection, hemorrhage and first bite syndrome. There were three recurrences, but neither recurrence nor complications were associated with the type of surgical approach. Conclusion A simple transcervical approach is preferred for parapharyngeal space pleomorphic adenomas with narrow attachments to the deep lobe of the parotid gland and for pleomorphic adenomas originating in a minor salivary gland within the parapharyngeal space.
References
[1]
Bass RM (1982) Approaches to the diagnosis and treatment of tumors of the parapharyngeal space. Head Neck Surg 4: 281–289. doi: 10.1002/hed.2890040404
[2]
Gaughran GR (1959) The lateral pharyngeal cleft. Ann Otol Rhinol Laryngol 68: 1082–1096.
[3]
Shoss SM, Donovan DT, Alford BR (1985) Tumors of the parapharyngeal space. Arch Otolaryngol 111: 753–757. doi: 10.1001/archotol.1985.00800130085011
[4]
Carrau RL, Myers EN, Johnson JT (1990) Management of tumors arising in the parapharyngeal space. Laryngoscope 100: 583–589. doi: 10.1288/00005537-199006000-00006
[5]
Infante-Cossio P, Gonzalez-Cardero E, Gonzalez-Perez LM, Leopoldo-Rodado M, Garcia-Perla A, et al. (2011) Management of parapharyngeal giant pleomorphic adenoma. Oral Maxillofac Surg 15: 211–216. doi: 10.1007/s10006-011-0289-2
[6]
Cohen SM, Burkey BB, Netterville JL (2005) Surgical management of parapharyngeal space masses. Head Neck 27: 669–675. doi: 10.1002/hed.20199
[7]
Batsakis JG, Sneige N (1989) Parapharyngeal and retropharyngeal space diseases. Ann Otol Rhinol Laryngol 98: 320–321.
[8]
Olsen KD (1994) Tumors and surgery of the parapharyngeal space. Laryngoscope 104: 1–28. doi: 10.1288/00005537-199405000-00001
[9]
Khafif A, Segev Y, Kaplan DM, Gil Z, Fliss DM (2005) Surgical management of parapharyngeal space tumors: a 10-year review. Otolaryngol Head Neck Surg 132: 401–406. doi: 10.1016/j.otohns.2004.09.062
[10]
O'Malley BW Jr, Quon H, Leonhardt FD, Chalian AA, Weinstein GS (2010) Transoral robotic surgery for parapharyngeal space tumors. ORL J Otorhinolaryngol Relat Spec 72: 332–336. doi: 10.1159/000320596
[11]
Dimitrijevic MV, Jesic SD, Mikic AA, Arsovic NA, Tomanovic NR (2010) Parapharyngeal space tumors: 61 case reviews. Int J Oral Maxillofac Surg 39: 983–989. doi: 10.1016/j.ijom.2010.06.005
[12]
Zhi K, Ren W, Zhou H, Wen Y, Zhang Y (2009) Management of parapharyngeal-space tumors. J Oral Maxillofac Surg 67: 1239–1244. doi: 10.1016/j.joms.2008.09.003
[13]
Malone JP, Agrawal A, Schuller DE (2001) Safety and efficacy of transcervical resection of parapharyngeal space neoplasms. Ann Otol Rhinol Laryngol 110: 1093–1098.
[14]
Roh JL, Park CI (2008) Function-preserving parotid surgery for benign tumors involving the deep parotid lobe. J Surg Oncol 98: 42–45. doi: 10.1002/jso.21082
[15]
Mendelsohn AH, Bhuta S, Calcaterra TC, Shih HB, Abemayor E, et al. (2009) Parapharyngeal space pleomorphic adenoma: a 30-year review. Laryngoscope 119: 2170–2174. doi: 10.1002/lary.20496
[16]
Albergotti WG, Nguyen SA, Zenk J, Gillespie MB (2012) Extracapsular dissection for benign parotid tumors: A meta-analysis. Laryngoscope 122: 1954–1960. doi: 10.1002/lary.23396
[17]
Hughes KV 3rd, Olsen KD, McCaffrey TV (1995) Parapharyngeal space neoplasms. Head Neck 17: 124–130. doi: 10.1002/hed.2880170209
[18]
Yang TL, Hsiao TY, Wang CP, Lou PJ, Ko JY (2011) Extracapsular dissection for minimal resection of benign parapharyngeal tumor. Eur Arch Otorhinolaryngol 269: 2097–2102. doi: 10.1007/s00405-011-1855-9
[19]
Fliss DM, Rival R, Gullane P, Mock D, Freeman JL (1992) Pleomorphic adenoma: a preliminary histopathologic comparison between tumors occurring in the deep and superficial lobes of the parotid gland. Ear Nose Throat J 71: 254–257.
