A transpalatal approach to the parapharyngeal space

Myatt, H. M.; Remedios, D.

doi:10.1017/s0022215100136722

Cited by 15 publications

(12 citation statements)

References 8 publications

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“…Therefore, this technique should be indicated only for small benign lesions (\3 cm) which occupy the anterior parapharyngeal space [15]. Deep lobe parotid tumors of all types should be removed by an external approach so that the facial nerve can be identified with precision and preserved undamaged.…”

Section: Discussionmentioning

confidence: 99%

Giant Parapharyngeal Space Pleomorphic Adenoma of the Deep Lobe of Parotid Presenting as Obstructive Sleep Apnoea: A Case Report & Review of the Diagnostic and Therapeutic Approaches

Datarkar

Deshpande

2014

J. Maxillofac. Oral Surg.

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Introduction Salivary gland tumours constitute about less than 4 % of all head and neck tumours. Pleomorphic adenoma, also called benign mixed tumour, is the most common tumour of the salivary glands. About 80-90 % of these tumours occur in the major salivary gland mainly parotid gland and 10 % of them occur in the minor salivary glands. Aims and Methods Aim of this case report is to discuss the unique case of giant parotid pleomorphic adenomas arising in the deep lobe involving the parapharyngeal space and difficulty in respiration at sleep during nights repoted at this institute. The patient was undergoing treatment for obstructive sleep apnea syndrome when she reported at this institute for disturbed sleep. Diagnosis was based on computed tomography scan and magnetic resonance imaging and cytology by means of fine needle aspiration biopsy. Conclusion An exhaustive pre-operative diagnostic algorithm is mandatory before approaching such lesions involving parapharyngeal space. Fine needle aspiration biopsy is, in our opinion, mandatory to avoid histological surprises. The surgical approach varies according to the location of the tumour and should provide excellent visibility with wide surgical exposure to secure local neurovascular structures.

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Section: Discussionmentioning

confidence: 99%

Giant Parapharyngeal Space Pleomorphic Adenoma of the Deep Lobe of Parotid Presenting as Obstructive Sleep Apnoea: A Case Report & Review of the Diagnostic and Therapeutic Approaches

Datarkar

Deshpande

2014

J. Maxillofac. Oral Surg.

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“…1 In addition to a traditional transpalatal approach to the skull base, an approach to the parapharyngeal space via the soft palate has been described. 12 This approach can be combined with an EEA or other approaches for resection of lesions with extent to the parapharyngeal space. To perform this approach, the lateral soft palate is infiltrated with 1% lidocaine with 1:100000 epinephrine.…”

Section: Transpalatal Approachmentioning

confidence: 99%

Transpalatal Approaches to the Skull Base and Reconstruction: Indications, Technique, and Associated Morbidity

London

Chan

Carrau

2020

Seminars in Plastic Surgery

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Multiple anterior surgical approaches are available to obtain access to the nasopharynx, clivus, and craniocervical junction. These include the direct and transoral robotic surgery transpalatal, maxillary swing, and endoscopic endonasal approaches. In this article, we describe the indications for these techniques, surgical steps, and associated morbidities. This article is a PubMed literature review. A review of the literature was conducted to assess the techniques, surgical steps, and associated morbidities with transpalatal approaches to the skull base and nasopharynx. The transpalatal approach has been traditionally utilized to obtain surgical access to the nasopharynx, clivus, and craniocervical junction. Morbidity includes velopalatine insufficiency due to shortening of the soft palate from scar contraction or neuromuscular damage, thus leading to hypernasal speech and dysphagia. Middle ear effusion and oronasal or oronasopharyngeal palatal fistula are additional potential morbidities. The choice of surgical approach depends on a variety of factors including the disease location and extent, surgeon experience, and available resources.

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“…In both cases, this kind of surgical technique was used, given the characteristics of the lesion; in fact, the dimensions and position in the deep parotid lobe allowed a trans-parotid approach to be performed. [9,10] The incidence of malignant transformation increases with time elapsing prior to surgery. Carcinoma ex-pleomorphic adenoma is usually an aggressive tumor.…”

Section: Casementioning

confidence: 99%

Tumours of Parapharyngeal Space Without Oropharyngeal Swelling: A Series of Two Cases

S.K¹,

Agrawal²,

Kumar³

et al. 2016

jebmh

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The parapharyngeal space is a complex anatomical area. Tumors located in the parapharyngeal space are relatively rare and account for 0.5% of all the head and neck tumors. Pleomorphic adenoma is the most common parapharyngeal space tumor. The clinical features are slow growing swelling of parotid and upper cervical region, bulging on lateral oropharyngeal wall, dysphagia, u/l Eustachian tube dysfunction, pain, trismus, and obstructive sleep apnoea. The pre-styloid tumours displace the lateral pharyngeal wall medially, parotid gland laterally and carotid artery laterally while maintain the fat plane with deep lobe of parotid gland. Post-styloid tumour displace the carotid artery medially and anteriorly with obliteration of fat plane around the vessels and pre-styloid fat anterolaterally. We report a series of two cases of pleomorphic adenoma, involving the prestyloid parapharyngeal space, and in continuity with the deep lobe of the parotid gland. However no medial bulge was seen on lateral oropharyngeal wall. Complete excision of the lesion was performed using the cervical-transparotid approach preserving the facial nerve. Main aim of our study is to emphasize that the parapharyngeal tumors are not always presented with oropharyngeal symptoms like lateral pharyngeal wall bulge, dysphagia, dysarthria and trismus.

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A transpalatal approach to the parapharyngeal space

Cited by 15 publications

References 8 publications

Giant Parapharyngeal Space Pleomorphic Adenoma of the Deep Lobe of Parotid Presenting as Obstructive Sleep Apnoea: A Case Report & Review of the Diagnostic and Therapeutic Approaches

Giant Parapharyngeal Space Pleomorphic Adenoma of the Deep Lobe of Parotid Presenting as Obstructive Sleep Apnoea: A Case Report & Review of the Diagnostic and Therapeutic Approaches

Transpalatal Approaches to the Skull Base and Reconstruction: Indications, Technique, and Associated Morbidity

Tumours of Parapharyngeal Space Without Oropharyngeal Swelling: A Series of Two Cases

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