Approaches to the diagnosis and treatment of tumors of the parapharyngeal space

Bass, R.M.

doi:10.1002/hed.2890040404

Cited by 94 publications

(43 citation statements)

References 19 publications

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“…Mandibulotomy, however, allows wider and safer access to the parapharyngeal space, with better control for adequate tumor excision. Various techniques involving osteotomy of the ramus [26][27][28][29][30], the angle or the body of the mandible have been described. All, however, involve resection of the inferior alveolar nerve within the bone except paramedian mandibulotomy.…”

Section: Discussionmentioning

confidence: 99%

Swing Mandibulotomy Access to Deep Lobe Parotid Tumors Case Reviews

Nayyar¹

2016

MOJCR

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Introduction: To utilize Swing mandibulotomy approach for gaining access to the deep lobe parotid tumors and to evaluate the functional and esthetic results.Case series: In the present case series, two patients were selected on standard criterion based on histological type, site, age, sex, clinical features, radiological evaluation, recurrence of the parotid tumors and surgical access to these tumors. Patients selected on eligibility criteria were evaluated and underwent, further, radiological evaluation and were surgically managed. Thereafter, long term follow-up was done clinically as well as radiologically. Successful surgical outcome was determined on the basis of functional and clinical recovery. Conclusion:Selecting the best approach to maximize visibility, ensure complete removal of the tumor and to reduce morbidity is an important decision to be made. Mandibulotomy provides an excellent mandible sparing surgical approach to gain access to deep lobe parotid tumors which are otherwise not accessible without procedures which leave significant morbidity.

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Section: Discussionmentioning

confidence: 99%

Swing Mandibulotomy Access to Deep Lobe Parotid Tumors Case Reviews

Nayyar¹

2016

MOJCR

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“…Approach for such tumours is always debatable and one must agree on the need to perform surgery requiring adequate exposure to identify and protect vital structures and ensure complete removal [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…The dissection continued posteriorly and inferiorly around the mandible. Mandibulotomy can be performed if necessary to improve exposure [12].…”

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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“…Transparotid approach is commonly used for deep lobe parotid tumors, especially for dumbbell shaped lesions and was initially described by Bass [8].…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have condemned the transoral approach as inadequate and unsafe [3]. Authors have stated that the transoral approach should be used only for small lesions not extending to the styloid process [8]. Betka et al performed transoral resection of tumor in 23 patients without any complications based on which they claim that transoral approach is a safe surgery [9].…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Parapharyngeal Space Tumors: Our Experience

Metgudmath

Malur

et al. 2012

Indian J Otolaryngol Head Neck Surg

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The purpose of this study is to evaluate parapharyngeal space (PPS) tumors with regards to clinicopathological features and pre-operative assessment and also to analyze the benefits of transcervical approach in the management of PPS tumors. We performed retrospective analysis of patients who had undergone transcervical resection of PPS tumors from May 2006 to May 2009 at KLES Dr. Prabhakar Kore Hospital and M. R. C, Belgaum. Patients were diagnosed on the basis of clinical examination, FNAC and magnetic resonance imaging. All patients were observed with an annual follow-up of at least 3 years by physical examination and ultrasonographic evaluation. The total number of patients were four; with three males and one female patient. Their age varied from 20 to 55 years with a mean age of 36 years. There were two cases of neurilemomas, one case of carotid body tumor and one case of pleomorphic adenoma. All four patients underwent surgical excision of tumor by transcervical approach. There were no major post-operative complications. All four patients are alive with no recurrence in the 3 year follow-up period. Transcervical approach is versatile, flexible and provides good access to the narrow PPS. This approach also provides good vascular control and reduced risk of post-op complications. We recommend transcervical approach even for large sized pre-styloid and post-styloid compartment benign tumors which are free from deep lobe of parotid.

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Approaches to the diagnosis and treatment of tumors of the parapharyngeal space

Cited by 94 publications

References 19 publications

Swing Mandibulotomy Access to Deep Lobe Parotid Tumors Case Reviews

Swing Mandibulotomy Access to Deep Lobe Parotid Tumors Case Reviews

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

Surgical Management of Parapharyngeal Space Tumors: Our Experience

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