Surgical Approaches and Postoperative Complcations of Parapharyngeal Space Tumours

Abstract

In this study we paid a special attention to analysis of surgical interventions conducted using transcervical, transparotid and transoral approach for neoplasm removal and revise complications arising in postoperative period in various types of PPS tumors. Results. The largest number of patients presented with benign salivary gland tumors 22 (68.7%), followed by malignant salivary gland neoplasms 5 (18.5%), neurogenic tumors 4 (12.5%), and miscellaneous tumors 1 (0.3%). Postoperative complications for malignant salivary gland surgeries occurred at the highest rate (42%), whereas, for benign -at the lowest (5%). Transcervicalsubmandibular, transparotid, and transoral approach was used in 56, 25, and 1% of surgeries, accordingly, whereas, mandibulotomy applied in 17%. "First bite syndrome" was noticed in 30% of the cases, cranial nerve palsies -in 20%, temporary, permanent facial nerve and accessorial nerve injury in 4, 1 and 15% of surgical interventions, accordingly. Vascular trunks damage occurred at 9%, and, mostly, for poststyloid lesions. Conclusions. Heterogeneous PPS tumors show a wide spectrum of postoperative complications and require a selective approach for optimization of surgical intervention and treatment strategy. MATERIALS AND METHODS

Secret Window to the Parapharyngeal Space: The Transcervical Transdigastric Approach

“…5 The incidence of cranial nerve deficit is related to the nature of tumor, whereby surgery involving malignant or neurogenic tumors are at higher risk of postoperative cranial nerve dysfunction. 5,9 Where mandibulotomy is performed, there is risk of temporomandibular joint dysfunction, nonunion, plate extrusion, and tooth loss. 9 As mentioned earlier, there are many methods practiced by surgeons worldwide in accessing the PPS.…”

“…5,9 Where mandibulotomy is performed, there is risk of temporomandibular joint dysfunction, nonunion, plate extrusion, and tooth loss. 9 As mentioned earlier, there are many methods practiced by surgeons worldwide in accessing the PPS. The transcervical transdigastric approach that we would like to highlight in this report begins with a curvilinear skin incision made approximately 2 finger breadths below the lower border of the mandible, followed by raising the subplatysmal flap up to the level of the mandible.…”