Faisal Muhammad, Seemann Rudolf, Fischer Gregor, Lill Claudia, Hamzavi Sasan, Wutzl Arno, Erovic Boban M
Shaukat Khanum Memorial Cancer Hosital and Research Centre, Lahore, Pakistan.
Department of Head and Neck Surgery, Evangelisches Krankenhaus Vienna, Vienna, Austria.
Int Arch Otorhinolaryngol. 2022 Oct 21;27(1):e158-e165. doi: 10.1055/s-0042-1744164. eCollection 2023 Jan.
Parapharyngeal space tumors with complex anatomy and diverse histology have remained a challenging phenomenon for treating physicians. We have conducted a comprehensive web search on the PubMed, Web of Science, EMBASE, Cochrane Library, Biomedical Literature Database (CBM), and Clinicaltrials.gov databases to determine the factors that are associated with postoperative complications in parapharyngeal space tumors. Two researchers reviewed all identified articles independently with a third reviewer for adjudication. Patient demographics and other clinicopathological characteristics were explored. The systematic review has identified 631 benign parapharyngeal space tumors with neurogenic and salivary tissue histology in 13 studies, with a mean age of 42.9 ± 7.76 years old and a median follow-up of 40.98 ± 19.1 months. Salivary gland (50.8%) and neurogenic (49.1%) tumors were the most common histological entities. Tumor size, location, histology, deep parotid lobe involvement, and proximity to great vessels or to the skull base were the deciding factors in selecting the surgical approach. The factors considered to select the surgical approach do not seem to have a correlation with the outcome in terms of neurological sequalae ( = 0.106). Tumors with neurogenic histology have significantly increased chances of developing neurological complication (OR 6.07; = 0.001). Neurologic complications are significantly associated with neurogenic benign tumors rather than surgical approach.
咽旁间隙肿瘤解剖结构复杂，组织学类型多样，一直是治疗医生面临的挑战。我们在PubMed、科学网、EMBASE、Cochrane图书馆、生物医学文献数据库（CBM）和Clinicaltrials.gov数据库上进行了全面的网络搜索，以确定与咽旁间隙肿瘤术后并发症相关的因素。两名研究人员独立审查所有已识别的文章，由第三名审查员进行裁决。探讨了患者人口统计学和其他临床病理特征。系统评价在13项研究中确定了631例具有神经源性和唾液腺组织学特征的良性咽旁间隙肿瘤，平均年龄为42.9±7.76岁，中位随访时间为40.98±19.1个月。唾液腺肿瘤（50.8%）和神经源性肿瘤（49.1%）是最常见的组织学类型。肿瘤大小、位置、组织学、腮腺深叶受累情况以及与大血管或颅底的接近程度是选择手术入路的决定因素。就神经后遗症而言，选择手术入路所考虑的因素似乎与结果无关（P=0.106）。具有神经源性组织学特征的肿瘤发生神经并发症的几率显著增加（OR 6.07；P=0.001）。神经并发症与神经源性良性肿瘤显著相关，而非手术入路。
