Selection of the surgical approach for lesions with parapharyngeal space involvement: A single-center experience on 153 cases

Lombardi, Davide; Ferrari, Marco; Paderno, Alberto; Taboni, Stefano; Rampinelli, Vittorio; Barbara, Francesco; Schreiber, Alberto; Mattavelli, Davide; Tomasoni, Michele; Farina, Davide; Ravanelli, Marco; Maroldi, Roberto; Nicolai, Piero

doi:10.1016/j.oraloncology.2020.104872

Cited by 21 publications

(10 citation statements)

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“…Lombardi et al, in 2020, proposed an algorithm for selecting surgical approach to resect PPS lesion. 20 If the planned resection extends toward the upper PPS like our patient, it is recommended to use the transparotid transcervical approach.…”

Section: Discussionmentioning

confidence: 92%

Nodular Oncocytic Hyperplasia of Bilateral Parotid Glands With Parapharyngeal Space Extension

2020

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Oncocytic tumors comprise a group of rare benign neoplasm of salivary glands, accounting for less than 1% of all salivary gland tumors. Nodular oncocytic hyperplasia characterized by multiple unencapsulated oncocytic nodules in the salivary glands is an extremely rare condition. We report a case of bilateral nodular oncocytic hyperplasia of parotid glands with parapharyngeal space extension in an 80-year-old woman whose initial presentation was recurrent parotitis. Our case may be the first report of nodular oncocytic hyperplasia in the parapharyngeal space, arising from the parotid gland. The patient underwent total parotidectomy and excision of parapharyngeal tumors using a transparotid transcervical approach, and at the 2-year follow-up, no evidence of recurrence was found.

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Section: Discussionmentioning

confidence: 92%

Nodular Oncocytic Hyperplasia of Bilateral Parotid Glands With Parapharyngeal Space Extension

2020

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“…1–9 Since parapharyngeal space salivary gland tumors mainly occur in the prestyloid compartment, a transcervical approach is mainly used. 1,3,5,7–9 In this study, the transcervical approach was used most frequently, followed by the transcervicalparotid approach. The choice between the 2 methods was mainly determined by whether the primary site of the parapharyngeal space salivary gland was the deep lobe of parotid gland or minor salivary gland in preoperative radiologic examinations.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Parapharyngeal Space Salivary Gland Tumor

Shin

Lee

et al. 2022

Journal of Craniofacial Surgery

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Introduction: Parapharyngeal space salivary gland tumors are very rare. The authors sought to examine the clinical features, treatment methods, and treatment results of parapharyngeal space salivary gland tumors in our hospital. Methods: The authors retrospectively enrolled 15 patients who were finally diagnosed as having parapharyngeal space salivary gland tumors from January 2010 to January 2021. Results: All parapharyngeal space salivary gland tumors arose from the prestyloid compartment. This study included 3 males and 12 females. The main symptoms were incidental diagnosis during imaging tests, followed by neck discomfort, oral mass, neck mass, and headache. Surgical methods for parapharyngeal space salivary gland tumors were performed in the following order: transcervical approach (n = 10), transcervical-parotid approach (n = 3), transoral approach (n = 1), and transparotid approach (n = 1). Pleomorphic adenoma was the most common tumor among parapharyngeal space salivary gland tumors. Conclusions: In the surgery of parapharyngeal space salivary gland tumors, a transcervical or transcervical-parotid approach was mainly used by predicting the origin site through radiologic examinations.

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“…Every effort towards reducing surgical invasiveness, e.g., avoiding nerve exposure and surgical dissection around the tumor with preservation of a cuff of healthy tissue around it (“extracapsular dissection”, Figure 2 ), was not received with open arms and encountered skepticism among several working groups [ 1 , 17 , 18 ]. Remarkably, this otherwise highly controversial surgical modality is accepted as one of the most common and undoubtedly least invasive ways of managing the same lesions in the parapharyngeal space [ 15 , 19 , 20 , 21 , 22 ]. In fact, extracapsular dissection in the parapharyngeal space tends to take the form of capsular dissection (or extracapsular enucleation [ 23 ]) around a large amount of surface of the PA.…”

Section: Discussionmentioning

confidence: 99%

Pleomorphic Adenoma of the Parotid Gland and the Parapharyngeal Space: Two Diametrically Opposing Surgical Philosophies for the Same Histopathologic Entity?

Hornung

Constantinidis

Thimsen

et al. 2021

JCM

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Background: The aim of this study was to investigate the histopathologic findings in parotid and parapharyngeal pleomorphic adenomas and draw conclusions concerning the surgical strategy. Methods: Retrospective study of medical charts of patients with resected pleomorphic adenomas (PA) between 2005 and 2020 at two tertiary medical referral centers. Histologic specimens were reexamined by an experienced head and neck pathologist. Patients with insufficient/incomplete data were excluded from our study sample. Results: A total of 844 patients formed our study sample (291 men, 553 women, average age 48.9 years); 786 cases had a PA in the parotid gland (PG) (93.1%), and the remaining 58 cases had a PA in the parapharyngeal space (PS) (6.9%). Recurrences were detected in 8/844 cases (7/786 in the PG, 1/58 in the PS, 0.94% in total) with a mean follow-up time of 86.7 months (10–189 months) with no statistically significant differences between the study groups (p = 0.527). Our analysis showed that parapharyngeal pleomorphic adenomas are characterized by a lower incidence of an intact anatomical capsule (71.4% vs. 82.6%, p = 0.035) and a remarkably more frequent occurrence of satellite nodules (20.7% vs. 7.5%, p < 0.001). Conclusions: The more challenging histopathologic profile of parapharyngeal pleomorphic adenomas points towards the fact that parapharyngeal surgery should remain in the hands of experienced surgeons at high-volume centers.

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Selection of the surgical approach for lesions with parapharyngeal space involvement: A single-center experience on 153 cases

Cited by 21 publications

References 50 publications

Nodular Oncocytic Hyperplasia of Bilateral Parotid Glands With Parapharyngeal Space Extension

Nodular Oncocytic Hyperplasia of Bilateral Parotid Glands With Parapharyngeal Space Extension

Surgical Treatment of Parapharyngeal Space Salivary Gland Tumor

Pleomorphic Adenoma of the Parotid Gland and the Parapharyngeal Space: Two Diametrically Opposing Surgical Philosophies for the Same Histopathologic Entity?

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