Francesco Chu1, Marta Tagliabue1, Gioacchino Giugliano1, Luca Calabrese1, Lorenzo Preda2, Mohssen Ansarin3. 1. Department of Head and Neck Surgery and Otorhinolaryngology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. 2. Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia - National Center of Oncological Hadrontherapy (CNAO Foundation), Str. Privata Campeggi, 53, 27100 Pavia, Italy. 3. Department of Head and Neck Surgery and Otorhinolaryngology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. Electronic address: mohssen.ansarin@ieo.it.
Abstract
PURPOSE: Parapharyngeal space (PPS) tumors are rare, accounting for 0.5% of all head-and-neck masses. Surgery remains the standard treatment for most cases, including different approaches (cervical approach, parotidectomy, mandibulotomy, transoral/robotic). We report our experience in the management of PPS tumors, aiming to create a surgical algorithm on the base of tumor's radiological and clinical characteristics. MATERIALS AND METHODS: Critical retrospective analysis of patients with PPS neoplasms who underwent surgery at our Institute. Data were collected on patient age and sex, tumor location and size, preoperative investigations, surgical approaches, histopathology, complications and outcomes. RESULTS: Between January 2000 and July 2015, 53 patients were treated at our Institute. Salivary gland tumors were the most common neoplasms followed by neurogenic tumors. CT scan/MRI were the most used preoperative imaging studies. The cervical approach with or without parotidectomy is the most used, providing the best compromise between the need for radicality and low risk of damage to the neurovascular structures. Mandibulotomy is used whenever the mass extends to the cranial base, assuming a higher morbidity, a slower functional recovery and the need for tracheotomy. Recently, TORS has been used for tumors of the PPS with promising outcomes. CONCLUSIONS: PPS surgery includes a wide spectrum of approaches but it is still a matter of debate which one guarantees better functional and oncological outcomes. We report a surgical algorithm based on surgical invasiveness and tumor characteristics to standardize PPS tumors management. We also highlight the upcoming role of TORS in this field.
PURPOSE: Parapharyngeal space (PPS) tumors are rare, accounting for 0.5% of all head-and-neck masses. Surgery remains the standard treatment for most cases, including different approaches (cervical approach, parotidectomy, mandibulotomy, transoral/robotic). We report our experience in the management of PPS tumors, aiming to create a surgical algorithm on the base of tumor's radiological and clinical characteristics. MATERIALS AND METHODS: Critical retrospective analysis of patients with PPS neoplasms who underwent surgery at our Institute. Data were collected on patient age and sex, tumor location and size, preoperative investigations, surgical approaches, histopathology, complications and outcomes. RESULTS: Between January 2000 and July 2015, 53 patients were treated at our Institute. Salivary gland tumors were the most common neoplasms followed by neurogenic tumors. CT scan/MRI were the most used preoperative imaging studies. The cervical approach with or without parotidectomy is the most used, providing the best compromise between the need for radicality and low risk of damage to the neurovascular structures. Mandibulotomy is used whenever the mass extends to the cranial base, assuming a higher morbidity, a slower functional recovery and the need for tracheotomy. Recently, TORS has been used for tumors of the PPS with promising outcomes. CONCLUSIONS:PPS surgery includes a wide spectrum of approaches but it is still a matter of debate which one guarantees better functional and oncological outcomes. We report a surgical algorithm based on surgical invasiveness and tumor characteristics to standardize PPS tumors management. We also highlight the upcoming role of TORS in this field.
Authors: Poonam Joshi; Kamal Deep Joshi; Sudhir Nair; Muddasir Bhati; Deepa Nair; Munita Bal; Amit Joshi; Naveen Mummudi; Vidisha Tuljapurkar; Devendra A Chaukar; Pankaj Chaturvedi Journal: South Asian J Cancer Date: 2021-11-24
Authors: Philippe Gorphe; Anne Auperin; Jean-François Honart; Jean Ton Van; Sophie El Bedoui; François Bidault; Stéphane Temam; Frédéric Kolb; Quentin Qassemyar Journal: Laryngoscope Investig Otolaryngol Date: 2018-03-25