Endoscopy-assisted transoral resection of parapharyngeal space tumors: a retrospective analysis

The technique of endoscopy-assisted transoral approach (EATA) has improved greatly, which should provide a better alternative for parapharyngeal space (PPS) tumors. Here, we compared curative effects between the resection of parapharyngeal space (PPS) tumors by EATA and external approaches (EAs), including the transcervical, transparotid, and transmandibular approaches. Based on the tumors' position and the relationship with adjacent structures, we selected 20 patients with parapharyngeal space tumor hospitalized in the Second People's Hospital in Shenzhen from January 2008 to December 2013, which were divided into the observation group and the control group with patients' informed consents. In the observation group, the tumors were removed solely by transoral approach under the guidance of endoscopes (EATA), while in the control group, the tumors were resected completely using an external approach (EA). We compared the total removal rate, the operation time, blood loss, postoperative pain, hospitalized time, complication rate, scar, and recurrence between the two groups. All the tumors were completely removed and patients were followed up for 6 months-5 years with no recurrence in either group. There was no significant difference regarding total removal rate, operation time, complication rate, and recurrence rate between the two groups (P > 0.05). However, significant differences were observed in blood loss, hospitalized time, and postoperative pain between the two groups (P < 0.05). PPS tumors could be completely removed by both EATA and EA. However, EATA has advantages of shortened hospitalized time, alleviated blood loss and postoperative pain level, and preservation of facial cosmetic.