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Parapharyngeal space benign tumours: our experience
Andrea Cassoni1, Valentina Terenzi1, Marco Della Monaca1
1Maxillo-Facial Surg. Dept, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
Summary
Parapharyngeal space (PPS) tumors are rare, with 80% being benign. Our 16-year study of 60 cases shows mandibulotomy is not recommended. Transparotid and transcervical approaches are preferred for safe, effective benign PPS tumor removal.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Neurosurgery
Background:
- Parapharyngeal space (PPS) neoplasms are rare, constituting ~0.5% of head and neck tumors.
- Approximately 80% of PPS tumors are benign lesions.
- Surgical management of PPS tumors often involves complex approaches, with some historically utilizing mandibulotomy for enhanced exposure.
Purpose of the Study:
- To review a 16-year surgical experience with 60 benign parapharyngeal space tumors.
- To evaluate and compare the efficacy and safety of different surgical approaches for benign PPS tumors.
- To determine the current role of mandibulotomy in the surgical management of benign PPS tumors.
Main Methods:
- Retrospective analysis of 60 patients treated for benign PPS tumors over 16 years.
- Detailed review of surgical techniques, focusing on exposure and structural safety.
- Comparison of outcomes between transparotid, transcervical, and mandibulotomy approaches.
Main Results:
- Mandibulotomy is not advocated for benign PPS tumors, even in select cases, based on extensive experience.
- The transparotid approach is the preferred method for parotid gland lesions extending into the PPS and for recurrent pleomorphic adenomas.
- The transcervical approach is effective and safe for removing even large benign PPS masses.
Conclusions:
- Mandibulotomy is generally contraindicated for benign parapharyngeal space tumors.
- Transparotid and transcervical approaches offer safe and effective surgical management for benign PPS tumors.
- Surgical technique selection should prioritize adequate mass exposure and preservation of adjacent structures.
