Parapharyngeal Space Tumor: Submandibular Approach Without Mandibulotomy

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Oncology

Background:

• Parapharyngeal space tumors are rare, accounting for 0.5% of head and neck neoplasms.
• Approximately 80% of these tumors are benign.
• The deep location necessitates diverse surgical approaches for effective resection.

Purpose of the Study:

• To evaluate the efficacy and safety of the submandibular transcervical approach for parapharyngeal tumor resection.
• To describe surgical outcomes in patients treated with this technique.

Main Methods:

• Retrospective, descriptive case-series analysis of 14 patients.
• Tumors treated between January 2009 and July 2016, excluding carotid body tumors.
• Submandibular transcervical approach utilized for upfront surgical treatment.

Main Results:

• Common presenting symptoms included foreign body sensation and pain.
• Complete tumor resection was achieved in all cases.
• The major complication was massive bleeding in one patient (7.1%).

Conclusions:

• The submandibular transcervical approach is a safe and effective method for resecting large parapharyngeal tumors, including those near the skull base.
• This technique offers advantages over mandibulotomy, with a minimal complication rate.
• Consideration for tumors up to 7 cm, especially those ≥0.5 cm from the skull base, is recommended.