Parapharyngeal space metastasis from squamous cell carcinoma: indications and limits of different surgical approaches

The aim of this review is to investigate the most suitable surgical approach to managing parapharyngeal space (PPS) squamous cell carcinoma (SCC) metastasis.

SCC metastasis in PPS are extremely rare. The PPS itself is a complex anatomical area, requiring extensive surgical experience and various surgical approaches for effective management. Several authors have attempted to systematize the surgical approaches to the PPS based on the anatomical location and histological nature of the lesions. However, there are currently few studies in the literature on the specific management of SCC metastases in the PPS, as these lesions are extremely rare.

The treatment of SCC metastases in the PPS must be determined based on the individual patient. If the patient is a candidate for surgery, the surgical approach should be chosen based on the location of the metastases and must ensure a sufficiently wide surgical corridor to allow for as complete a resection as possible. To date, the surgical approach that best meets these requirements is the transcervical transparotid approach. With new technologies, including the use of robotics and endoscopy, surgery can become increasingly less invasive while maintaining the wide exposure provided by open surgical procedures.