Therapie parapharyngealer Tumoren

Abstract

The parapharyngeal space extends from the nasopharynx to the oropharynx. It is bordered medially by the pharyngeal wall and the constrictor pharyngis muscles, and laterally by the mandible. One distinguishes between a pre- and a poststyloid space. Tumors of the parapharyngeal space are rare and represent less than 1 % of all head and neck neoplasms. Benign (70-80 %) as well as malignant (20-30 %) tumors arise from different structures of the parapharyngeal space, mainly from salivary glands and nerve structures. Concerning salivary gland tumors, most are pleomorphic adenomas typically appearing in the prestyloid space, whereas the schwannomas that may also arise are located in the poststyloid space. The main symptom is dysphagia, with the tumor generally presenting as a visible bulking of the pharyngeal wall, in rare cases also as an externally visible cervical mass. Treatment is generally surgical resection, particularly in benign tumors, preferably via transcervical access. If R0 resection of malignancies is possible, this should be performed. In malignant lymphomas and nonresectable tumors, primary chemo-, radio-, or combination therapy should be considered after histologic confirmation. For neurogenic tumors, particularly vagal nerve schwannoma and especially in older patients, a wait-and-scan strategy is most favorable, since postoperative vagal palsy is unavoidable with surgical resection. Treatment planning for parapharyngeal space tumors requires good knowledge of topographic anatomy and careful evaluation of imaging findings.

Speech therapy rehabilitation in Tapia´s syndrome: case report

“…13 Schwannomas can originate in any nerve that has Schwan cells, except the optic nerve. 13,14 These tumours are usually encapsulated except those in the nasopharynx and sinonasal tract. The head and neck region are the most commonly affected (25-45%), with the lateral part of the neck being the most frequently involved area.…”

“…The head and neck region are the most commonly affected (25-45%), with the lateral part of the neck being the most frequently involved area. 14,15 They tend to occur between the ages of 30 and 60 13,14 They present as asymptomatic, slow-growing masses and the symptoms depend on the anatomical location of the tumour and the nerve of origin. Among the symptoms reported in most cases, dysphagia, dyspnea and dysphonia are the most mentioned.…”

“…Among the symptoms reported in most cases, dysphagia, dyspnea and dysphonia are the most mentioned. [13][14][15] In cases where the tumors manifest together in regions such as the parotid, the functional impairment may involve alterations in the stomatognathic functions, such as speech, mastication, suction, in addition to alterations in facial expressiveness. 16 Such changes can compromise the individual's emotional and psychosocial aspects, which directly interfere with their quality of life.…”

A Retrospective Analysis on the Effects and Complications of Endoscope-Assisted Transoral Approach and Lateral Cervical Approach in the Resection of Parapharyngeal Space Tumors

“…Considering the concealment of PSS, it is often di cult to detect PSS tumors in the early stage. It is generally believed that PSS tumor volume larger than 2.5 cm will lead to clinical symptoms, such as upper neck mass, lateral pharyngeal wall or glossopalatine arch surface eminence, throat foreign body sensation, sore throat, cough, dysphagia, tinnitus, snoring, and even dyspnea [4]. With the growth of the tumor, it will also lead to corresponding neurological dysfunction, characterized by hoarseness, ambiguous speech, limited mouth opening, Horner syndrome, and so on, which seriously affect the life of the patients [4].…”

“…It is generally believed that PSS tumor volume larger than 2.5 cm will lead to clinical symptoms, such as upper neck mass, lateral pharyngeal wall or glossopalatine arch surface eminence, throat foreign body sensation, sore throat, cough, dysphagia, tinnitus, snoring, and even dyspnea [4]. With the growth of the tumor, it will also lead to corresponding neurological dysfunction, characterized by hoarseness, ambiguous speech, limited mouth opening, Horner syndrome, and so on, which seriously affect the life of the patients [4]. e diagnosis of PSS tumors needs imaging examination for preoperative evaluation, according to the typical imaging features of the tumor to make a higher accuracy of preoperative diagnosis.…”