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Published on: August 15, 2025
Parapharyngeal space tumors without mandibulotomy: our experience
Livio Presutti1, Gabriele Molteni, Laura Malvè
1Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo 71, 41100 Modena, Italy.
Summary
This study shows that benign parapharyngeal space (PPS) tumors can be surgically removed without mandibulotomy, reducing patient morbidity. Avoiding this jaw-splitting procedure is feasible for most benign PPS tumors.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Surgical Oncology
Background:
- Parapharyngeal space (PPS) tumors are rare, with 80% being benign.
- Surgical approaches to PPS tumors are complex due to anatomical location and vital structures.
- Mandibulotomy is a traditional approach but associated with significant morbidity.
Purpose of the Study:
- To evaluate the feasibility and outcomes of surgical resection of benign PPS tumors without mandibulotomy.
- To compare transcervical and transcervical-transparotid approaches in avoiding mandibulotomy.
- To assess the impact of avoiding mandibulotomy on patient morbidity and hospital stay.
Main Methods:
- Retrospective review of 18 patients with benign PPS tumors treated between May 2003 and March 2009.
- Surgical resection performed using either a transcervical or transcervical-transparotid approach, deliberately avoiding mandibulotomy.
- Tumor histology confirmed benignancy, including pleomorphic adenomas, schwannomas, and paragangliomas.
Main Results:
- All 18 patients underwent successful tumor resection without mandibulotomy.
- Tumor sizes ranged, with an average of 5.5 × 4 × 3 cm.
- Seven patients had a transcervical approach, and 11 had a transcervical-transparotid approach.
Conclusions:
- Benign PPS tumors, even large ones, can be excised without mandibulotomy.
- Avoiding mandibulotomy significantly reduces patient morbidity and hospital stay.
- Mandibulotomy should be reserved for malignant tumors or cases with extremely poor surgical exposure.
