Markou Konstantinos, Blioskas Sarantis, Krommydas Argyrios, Psillas George, Karkos Petros
Department of Otorhinolaryngology - Head and Neck Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi St, 54636 Thessaloniki, Greece.
Iran J Otorhinolaryngol. 2019 Mar;31(103):87-96.
Parapharyngeal space (PPS) tumors account for 0.5% of the head and neck neoplasms. Based on the evidence, 80% of these tumors are of a benign nature. Surgical excision is the treatment of choice for this condition. The present study was conducted to propose transoral resection as an efficient way to excise the benign well-defined tumors of the PPS.
This retrospective case series study was conducted on seven patients undergoing the transoral excision of the sizeable masses of the PPS via a combined approach. Computed tomography and magnetic resonance scans revealed giant masses in the PPS in all cases. These neoplasms were preoperatively diagnosed as well-delineated, non-vascular, and benign.
All patients underwent transoral tumor excision preceded by an auxiliary transcervical approach, which served as an assurance for the dissection and preservation of the cranial nerves and neurovascular bundle without any tumor spillage. Average hospital stay was limited to a maximum of 3 days, and all patients had an uneventful postoperative course. The follow-up examination did not indicate any recurrence.
Based on the findings, transoral resection can be concluded as an efficient way to excise benign, well-defined tumors of the PPS. This procedure appears to be safe when a secondary transcervical approach is applied. Given the unnecessity of performing mandibulotomy in this procedure, it is expected to have lower morbidity and fewer complications.
咽旁间隙（PPS）肿瘤占头颈部肿瘤的0.5%。根据现有证据，这些肿瘤中80%为良性。手术切除是这种疾病的首选治疗方法。本研究旨在提出经口切除作为切除PPS良性边界清晰肿瘤的有效方法。
本回顾性病例系列研究对7例通过联合方法经口切除PPS巨大肿物的患者进行。计算机断层扫描和磁共振扫描显示所有病例的PPS均有巨大肿物。这些肿瘤术前被诊断为边界清晰、无血管且为良性。
所有患者在经口肿瘤切除前均采用辅助经颈入路，这为在不发生肿瘤溢出的情况下解剖和保留颅神经及神经血管束提供了保障。平均住院时间最长限制在3天，所有患者术后恢复顺利。随访检查未显示任何复发情况。
根据研究结果，经口切除可被认为是切除PPS良性边界清晰肿瘤的有效方法。当采用辅助经颈入路时，该手术似乎是安全的。鉴于此手术无需进行下颌骨切开术，预计其发病率较低且并发症较少。
