The surgical approach for parapharyngeal space tumors – a case series

The surgical excision of parapharyngeal space tumors might be challenging and requires precise knowledge of the topographic anatomy. The choice of the surgical approach depends on size and localisation of the tumor and is discussed on the basis of a case series.

From 2010 to 2017 5 cases of parapharyngeal space tumors were surgically treated in the ENT university clinic of Oldenburg. All cases were evaluated using a MRI and CT scan. Three pleomorphic adenomas of the prestyloidal space were resected via a transcervical approach, complemented by a laterocaudal parotidectomy in two cases. One pleomorphic adenoma of the deep lobe of the parotid gland was resected transorally, while another one, which extended from the prestyloidal space to the poststyloidal space and the pterygopalatine fossa, was resected via a combined transoral-transmandibular approach.

Conclusion:

Most of the prestyloidal space tumors can be resected by a transcervical or transoral access without difficulties. Lateralisation of the mandible with a surgical hook facilitates the transcervical approach.

In case of extended tumors into the pterygopalatine fossa, to the skull base or into the retrostyloidal space the surgical approach can be extended by a temporary median mandibulotomy or a lateral double osteotomy of the mandible.

Publication History

Publication Date:
18 April 2018 (online)