Clinical analysis and surgical treatment evaluation of 23 cases with primary parapharyngeal space tumors / 中华口腔医学杂志

Objective@#To analyze the clinical characters and surgical treatment of primary parapharyngeal space (PPS) tumors.@*Methods@#A total of 23 cases of primary PPS tumors which were treated from November 2011 to December 2017 were included for the retrospective analysis in this study.@*Results@#Twenty-three cases of patients with primary PPS tumors were analyzed in this study. Surgical approach was as follows: transcervial approach applied in 7 cases, transparotid approach in 4 cases, transoral approach in 2 cases, transmandibular approach in 4 cases, and the combined approaches on 6 cases. Besides, among 7 cases with upper PPS tumor, we applied the surgical navigation system in the surgery of 3 cases. The mean surgery duration of these cases, 3.5 h, was shorter than unused ones, while the mean maximum size (MMS) of tumors, 5.7 cm, was also larger. So far, 23 cases had no recurrence and metastasis. The most frequent histopathological type of all the cases was pleomorphic adenoma (8 cases), followed by Schwannoma (5 cases). With an 8-to-72-months follow up, 23 cases had no recurrence, metastasis or death.@*Conclusions@#Surgical resection is preferred in the treatment of PPS tumors. In the upper PPS tumor cases, the surgical navigation system could reduce the operative duration significantly and is more suitable for larger tumors.

Comparative Analysis of Diagnostic Tools for Parapharyngeal Tumors / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The parapharyngeal tumors are rare and treated mostly by surgical removal. The preoperative diagnosis of parapharyngeal tumors is very important because the surgical removal of neurogenic tumor, which is the main mass in the parapharyngeal space, can induce severe complications. There are many diagnostic tools for parapharyngeal tumors and their effectiveness are variable. In this study, we focused on the diagnostic accuracy of each diagnostic tool. SUBJECTS AND METHOD: We compared the preoperative diagnostic results with the final pathologic reports of 56 parapharyngeal tumors. Diagnostic tools used were computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), and fine needle aspiration biopsy (FNAB). RESULTS: The diagnostic accuracy of MRI, CT and US was 68.2%, 51.6% and 42.8%, respectively. The sensitivity (83%) and specificity (87.5%) of FNAB for neurogenic tumor are higher than those of MRI (75%, 50%). CONCLUSION: These results suggest that FNAB is the most precise and reliable diagnostic tool and MRI is the most reasonable and effective imaging study.

Mandibular Lingual Releasing Approach to Oral and OropharyngealCarcinoma and Parapharyngeal Space Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The objectives of treating oral cavity and oropharyngeal cancer are complete removal of tumor, restoration of function and aesthetics, and such treatments require adequate exposure for direct visual and bimanual examination. For posterior oral cavity and oropharynx, the standard approach had been the composite resection. This approach requires mandibulectomy and lip-splitting incision, and thus, complications of mandibulectomy can not be avoided. There is no standard approach for parapharyngeal space tumors due to limited exposure, but most authors have agreed that the best approach is the external approach with or without mandibulotomy. Mandibular lingual releasing approach (MLRA) to oral cavity, oropharynx and parapharyngeal space provides excellent visualization for resection of tumors without lip-splitting, mandibulotomy, nor mandibulectomy. We analyzed the outcome and advantage of MLRA. MATERIALS AND METHODS: We used MLRA to treat 7 patients who had oral cavity or oropharyngeal cancers and one who had parapharyngeal tumor. RESULTS: All tumors could be removed by MLRA. Postoperative complications were wound infection, orocutaneous fistula, and mouth floor wound disruption. But, permanent deficit and complications of lip-splitting, mandibulotomy, or mandibulectomy did not occured. CONCLUSION: The MLRA provides excellent exposure of oral cavity, oropharynx and parapharyngeal space and excellent cosmetic and functional results. It canbe concluded that the MLRA is an excellent approach for tumors of oral cavity, oropharynx and parapharyngeal space.