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Research Article | Volume 14 Issue:1 (Jan-Feb, 2024) | Pages 515 - 519
Management of parapharyngeal space tumours by transcervical and transoral approaches – A case series
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1
Associate Professor of ENT, GMC Srikakulam
2
Associate professor of ENT, SMC Vijayawada
3
Associate Professor of ENT, GMC Kadapa
4
Associate Professor of Gen Surgery.
5
Professor of ENT, GMC Srikakulam
Under a Creative Commons license
Open Access
DOI : 10.5083/ejcm
Received
Jan. 2, 2024
Revised
Jan. 17, 2024
Accepted
Jan. 30, 2024
Published
Feb. 3, 2024
Abstract

Introduction: Parapharyngeal space tumors are rare, accounting for 0.5% of all head &neck tumors. 80% of them are benign. Variety of tumor types can develop in this area, most common are salivary gland neoplasms & neurogenic tumors. Management of these tumors require diligent assessment and planning with due consideration of various anatomical and pathological aspects of the lesion. Several approaches have been described for excision of parapharyngeal space tumors. Transcervical approach is the most commonly used while the advances in endoscopy gave further stimulus to the use transoral route. Aim : The aim of this study is to present our experience with the Transcervical approach & Endoscopy assisted transoral approach (EATA) in the treatment of  parapharyngeal space tumors  and to review the most recent literature about both the approaches. Materials &methods: The study included 7 patients. Patients who underwent removal of parapharyngeal space tumors through transcervical approach & EATA in a tertiary care centre from 2016 to 2023 were retrospectively analyzed and the literature about the outcomes of both the techniques were systematically reviewed. Results : 7 cases of parapharyngeal space tumors were completely excised. Among them 3 cases were operated through transcervical approach and 4 cases through EATA. The mean age was 47.8 years with a male-to-female ratio of 4:3. The mean hospital stay was 3-4 days. Transcervical route was used for post styloid tumors (all 3 Neurofibromas), transoral route was used for pre styloid tumors (all 4 Pleomorphic adenomas). All tumors are benign. One case had postop vocal cord palsy while one case had post operative wound dehiscence. No recurrence was found after a mean followup of 9 months. Conclusion: Contrast CT & MRI are the most useful instruments for choosing the most appropriate surgical approach. Transoral approach is better for Prestyloid & non vascular tumors (benign encapsulated tumour) where as Trans cervical approach is useful for both Pre & Post styloid tumors and Vascular & Non vascular tumors. Complete excision has good prognosis & recurrence rates are rare for benign lesions. 

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