Aghazadeh Keyvan, Mohammadtaghi Khorsandi, Rikhtegar Mohamamadjavad, Sharifi Amirsina, Hashemiaghdam Arsalan, Hashem Zade Arezou
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Students' Scientific Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Otorhinolaryngol. 2020 Jan;32(108):43-48. doi: 10.22038/ijorl.2019.38350.2268.
Various surgical approaches to parapharyngeal space (PPS) tumors are introduced to obtain complete removal with the preservation of the surrounding structures in parapharyngealneoplasms. Here, we will discuss the main techniques and their outcome.
This retrospective study was conducted on 78 patients undergone either transoral, transcervical or a combination of these two approaches for the resection of PSS tumors from January 2010 to January 2015.
A number of 33 male and 45 female patients with the mean age of 40.9 ± 9.1 were evaluated. 42.3% of the patients were asymptomatic at the initial presentation. Pleomorphic adenoma and schwannoma were a permanent diagnosis in 61(78.2%) and 11(14.1%) patients, respectively. PPS tumors were resected using transoral, transcervical and combined approaches in 35(44.8%), 33(42.3%) and 10 (12.9%) cases, respectively. Recurrence occurred in 10 patients all of whom had apre-styloid pleomorphic adenoma, operated transcervical (P< 0.0001).Three cases of tenth nerve palsy occurred in schwannomas which were operatedtranscervically (P=0.04). Mean hospital stays were 2.11,3.69, and 4.9 days after transoral, transcervical and combined approaches, respectively (P= 0.001).
Transoral, transcervical and combined approaches are all able to provide adequate visualization with comparable outcomes.
为了在保留周围结构的情况下完整切除咽旁间隙（PPS）肿瘤，人们引入了各种手术方法来处理咽旁肿瘤。在此，我们将讨论主要技术及其结果。
本回顾性研究对2010年1月至2015年1月期间接受经口、经颈或这两种方法联合切除PSS肿瘤的78例患者进行。
评估了33例男性和45例女性患者，平均年龄为40.9±9.1岁。42.3%的患者初诊时无症状。多形性腺瘤和神经鞘瘤分别是61例（78.2%）和11例（14.1%）患者的最终诊断。PPS肿瘤分别采用经口、经颈和联合方法切除的病例数为35例（44.8%）、33例（42.3%）和10例（12.9%）。10例患者出现复发，所有复发患者均为茎突前多形性腺瘤，采用经颈手术（P<0.0001）。3例迷走神经麻痹发生在经颈手术的神经鞘瘤患者中（P=0.04）。经口、经颈和联合手术后的平均住院天数分别为2.11天、3.69天和4.9天（P=0.001）。
经口、经颈和联合方法均能提供足够的视野，且结果相当。
