Surgical Parapharyngeal Space Tumor Analysis with Case Series Study

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Surgery

Background:

• The parapharyngeal space (PPS) is a deep neck region containing uncommon neoplasms, accounting for <1% of head and neck tumors.
• Accurate diagnosis of PPS tumors requires both CT and MRI, with complete surgical excision being critical for treatment.
• Identifying and treating PPS tumors presents significant challenges due to their aggressive nature.

Purpose of the Study:

• To review current knowledge on parapharyngeal space tumors at King Abdulaziz University Hospital, Jeddah.
• To analyze clinical findings, tumor characteristics, histological distribution, and surgical approaches for PPS tumors.
• To evaluate the effectiveness of different surgical techniques for PPS tumor excision.

Main Methods:

• A case series of nine patients undergoing parapharyngeal space tumor excision between 2014 and 2018.
• Surgical approaches included transoral, transcervical, transparotid, transmandibular, and infratemporal techniques.
• All procedures were performed by an otolaryngology-head and neck surgeon.

Main Results:

• Nine patients were included in the study.
• Seven patients underwent a transcervical or combined transcervical/transparotid approach; two had a transparotid approach.
• One case of hematoma was the only complication reported.

Conclusions:

• The transcervical approach is the preferred surgical method for parapharyngeal space tumors, particularly pleomorphic adenomas and paragangliomas.
• This approach offers superior outcomes for tumors originating from the deep parotid lobe or within the PPS.
• Effective surgical management of PPS tumors requires careful consideration of the approach based on tumor type and location.