Surgical treatment of parapharyngeal space tumors: A report of 29 cases

Ijichi,Kei; Murakami,Shingo

doi:10.3892/ol.2017.6480

September-2017 Volume 14 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

September-2017 Volume 14 Issue 3

Full Size Image

Article

Surgical treatment of parapharyngeal space tumors: A report of 29 cases

Authors:
- Kei Ijichi
- Shingo Murakami
View Affiliations / Copyright

Affiliations: Department of Otolaryngology‑Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467‑8601, Japan
Pages: 3249-3254
|
Published online on: June 23, 2017

https://doi.org/10.3892/ol.2017.6480
Expand metrics +

Abstract

The present study aimed to establish a strategy for parapharyngeal space (PPS) tumor surgery based on preoperative symptoms, clinical signs, imaging and histological examination. A retrospective cohort study was conducted with 29 adult patients who underwent surgery for primary PPS tumors from 2008‑2015. The following data was obtained: Preoperative symptoms of the patient, histological type of the tumor, surgical approach and complications. Of the 29 patients who underwent surgery to remove a PPS tumor, 16 presented with neurogenic tumors and 13 with salivary gland tumors. The most common symptom was the presence of a neck mass. Preoperative computed tomography and magnetic resonance imaging were performed to evaluate the size and location of the tumors. The majority of the salivary gland tumors were located in the prestyloid space, whereas all neurogenic tumor cases were poststyloid. A total of 21 of the 29 patients (72.4%) underwent a preoperative fine needle aspiration (FNAC) examination. FNAC contributed to preoperative diagnosis in 9 of these cases (42.9%). In parotid tumors of the prestyloid space, facial nerve palsy was a common postoperative complication. In the case of neurogenic tumors, a common complication was the postoperative palsy of the nerve of tumor origin. The strategy for PPS surgery, from the preoperative diagnosis to the operative method, remains controversial. The data on pre‑ and postoperative symptoms, imaging and histological diagnosis, and the selection of surgical method depending on a neurogenic or salivary tumor origin in the present study indicated that improving the method of examination, carefully selecting the method of approach and accurately managing surgery leads to complete tumor removal, and that the use of nerve‑preserving techniques may reduce the likelihood of complications.

View Figures

View References

1	Curtin HD: Separation of the masticator space from the parapharyngeal space. Radiology. 163:195–204. 1987. View Article : Google Scholar : PubMed/NCBI
2	Basaran B, Polat B, Unsaler S, Ulusan M, Aslan I and Hafiz G: Parapharyngeal space tumours: The efficiency of a transcervical approach without mandibulotomy through review of 44 cases. Acta Otorhinolaryngol Ital. 34:310–316. 2014.PubMed/NCBI
3	Stell PM, Mansfield AO and Stoney PJ: Surgical approaches to tumors of the parapharyngeal space. Am J Otolaryngol. 6:92–97. 1985. View Article : Google Scholar : PubMed/NCBI
4	Cohen SM, Burkey BB and Netterville JL: Surgical management of parapharyngeal space masses. Head Neck. 27:669–675. 2005. View Article : Google Scholar : PubMed/NCBI
5	Batsakis JG and Sneige N: Parapharyngeal and retropharyngeal space diseases. Ann Otol Rhinol Laryngol. 98:320–321. 1989. View Article : Google Scholar : PubMed/NCBI
6	Carrau RL, Myers EN and Johnson JT: Management of tumors arising in the parapharyngeal space. Laryngoscope. 100:583–589. 1990. View Article : Google Scholar : PubMed/NCBI
7	Khafif A, Segev Y, Kaplan DM, Gil Z and Fliss DM: Surgical management of parapharyngeal space tumors: A 10-year review. Otolaryngol Head Neck Surg. 132:1–406. 2005. View Article : Google Scholar
8	Work WP and Hybels RL: A study of tumors of the parapharyngeal space. Laryngoscope. 84:1–1755. 1974. View Article : Google Scholar : PubMed/NCBI
9	Shahab R, Heliwell T and Jones AS: How we do it: A series of 114 primary pharyngeal space neoplasms. Clin Otolaryngol. 30:364–367. 2005. View Article : Google Scholar : PubMed/NCBI
10	Dimitrijevic MV, Jesic SD, Mikic AA, Arsovic NA and Tomanovic NR: Parapharyngeal space tumors: 61 case reviews. Int J Oral Maxillofac Surg. 39:983–989. 2010. View Article : Google Scholar : PubMed/NCBI
11	Allison RS, Van der Waal I and Snow GB: Parapharyngeal tumours: A review of 23 cases. Clin Otolaryngol Allied Sci. 14:199–203. 1989. View Article : Google Scholar : PubMed/NCBI
12	Kuet ML, Kasbekar AV, Masterson L and Jani P: Management of tumors arising from the parapharyngeal space: A systematic review of 1,293 cases reported over 25 years. Laryngoscope. 125:1372–1381. 2015. View Article : Google Scholar : PubMed/NCBI
13	Horowitz G, Ben-Ari O, Wasserzug O, Weizman N, Yehuda M and Fliss DM: The transcervical approach for parapharyngeal space pleomorphic adenomas: Indications and technique. PLoS One. 9:e902102014. View Article : Google Scholar : PubMed/NCBI
14	Olsen KD: Tumors and surgery of the parapharyngeal space. Laryngoscope. 104 5 Pt 2 Suppl 63:S1–S28. 1994. View Article : Google Scholar
15	Papadogeorgakis N, Petsinis V, Goutzanis L, Kostakis G and Alexandridis C: Parapharyngeal space tumors: Surgical approaches in a series of 13 cases. Int J Oral Maxillofac Surg. 39:243–250. 2010. View Article : Google Scholar : PubMed/NCBI
16	Eneroth CM: Histological and clinical aspects of parotid tumours. Acta Otolaryngol Suppl. 188 Suppl 191:S1–S99. 1964.
17	Hughes KV III, Olsen KD and McCaffrey TV: Parapharyngeal space neoplasms. Head Neck. 17:124–130. 1995. View Article : Google Scholar : PubMed/NCBI
18	Liu HL, Yu SY, Li GK and Wei WI: Extracranial head and neck Schwannomas: A study of the nerve of origin. Eur Arch Otorhinolaryngol. 268:1343–1347. 2011. View Article : Google Scholar : PubMed/NCBI
19	Tryggvason G, Barnett A, Kim J, Soken H, Maley J and Hansen MR: Radiographic association of schwannomas with sensory ganglia. Otol Neurotol. 33:1276–1282. 2012. View Article : Google Scholar : PubMed/NCBI
20	Som PM, Sacher M, Stollman AL, Biller HF and Lawson W: Common tumors of the parapharyngeal space: Refined imaging diagnosis. Radiology. 169:81–85. 1988. View Article : Google Scholar : PubMed/NCBI
21	Caldarelli C, Bucolo S, Spisni R and Destito D: Primary parapharyngeal tumours: A review of 21 cases. Oral Maxillofac Surg. 18:283–292. 2014. View Article : Google Scholar : PubMed/NCBI
22	Arnason T, Hart RD, Taylor SM, Trites JR, Nasser JG and Bullock MJ: Diagnostic accuracy and safety of fine-needle aspiration biopsy of the parapharyngeal space. Diagn Cytopathol. 40:118–123. 2012. View Article : Google Scholar : PubMed/NCBI
23	Zaharopoulos P: Diagnostic challenges in the fine-needle aspiration diagnosis of carotid body paragangliomas: Report of two cases. Diagn Cytopathol. 23:202–207. 2000. View Article : Google Scholar : PubMed/NCBI
24	Yu GH, Sack MJ, Baloch Z and Gupta PK: Difficulties in the fine needle aspiration (FNA) diagnosis of schwannoma. Cytopathology. 10:186–194. 1999. View Article : Google Scholar : PubMed/NCBI
25	Bass RM: Approaches to the diagnosis and treatment of tumors of the parapharyngeal space. Head Neck Surg. 4:281–289. 1982. View Article : Google Scholar : PubMed/NCBI
26	Luna-Ortiz K, Navarrete-Alemán JE, Granados-García M and Herrera-Gómez A: Primary parapharyngeal space tumors in a Mexican cancer center. Otolaryngol Head Neck Surg. 132:587–591. 2005. View Article : Google Scholar : PubMed/NCBI
27	Goodwin WJ Jr and Chandler JR: Transoral excision of lateral parapharyngeal space tumors presenting intraorally. Laryngoscope. 98:266–269. 1988. View Article : Google Scholar : PubMed/NCBI
28	Chan JY, Tsang RK, Eisele DW and Richmon JD: Transoral robotic surgery of the parapharyngeal space: A case series and systematic review. Head Neck. 37:293–298. 2015. View Article : Google Scholar : PubMed/NCBI
29	Kolokythas A, Eisele DW, El-Sayed I and Schmidt BL: Mandibular osteotomies for access to select parapharyngeal space neoplasms. Head Neck. 31:102–110. 2009. View Article : Google Scholar : PubMed/NCBI
30	Krishnamurthy S, Holmes B and Power SK: Schwannomas limited to the infratemporal fossa: Report of two cases. J Neurooncol. 36:269–277. 1998. View Article : Google Scholar : PubMed/NCBI
31	Presutti L, Molteni G, Malvè L, Marchioni D, Ghidini A, Tassi S, Chiarini L and Alicandri-Ciufelli M: Parapharyngeal space tumors without mandibulotomy: Our experience. Eur Arch Otorhinolaryngol. 269:265–273. 2012. View Article : Google Scholar : PubMed/NCBI
32	Yasumatsu R, Nakashima T, Miyazaki R, Segawa Y and Komune S: Diagnosis and management of extracranial head and neck schwannomas: A review of 27 cases. Int J Otolaryngol. 2013:9730452013. View Article : Google Scholar : PubMed/NCBI
33	Behuria S, Rout TK and Pattanayak S: Diagnosis and management of schwannomas originating from the cervical vagus nerve. Ann R Coll Surg Engl. 97:92–97. 2015. View Article : Google Scholar : PubMed/NCBI
34	Boufettal M, Azouz M, Rhanim A, Abouzahir M, Mahfoud M, Bardouni AE, Berrada MS and Yaacoubi ME: Schwannoma of the median nerve: Diagnosis sometimes delayed. Clin Med Insights Case Rep. 7:71–73. 2014. View Article : Google Scholar : PubMed/NCBI