Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T09:27:28.719Z Has data issue: false hasContentIssue false

Standardised method of selecting surgical approaches to benign parapharyngeal space tumours, based on pre-operative images

Published online by Cambridge University Press:  26 July 2007

S Kanzaki*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Shizuoka Red Cross Hospital, Otteemachi Aoi, Shizuoka, Tokyo, Japan Department of Otolaryngology, Keio University Medical School, Tokyo, Japan
H Nameki
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Shizuoka Red Cross Hospital, Otteemachi Aoi, Shizuoka, Tokyo, Japan
*
Address for correspondence: Dr Sho Kanzaki, Department of Otolaryngology, Keio University Medical School, 35 Shinanomachi, Shinjuku, Tokyo, Japan. E-mail: [email protected]

Abstract

Many approaches to the parapharyngeal space have been reported. However, few reports describe parapharyngeal space tumours and the best surgical approach to these tumours. We retrospectively examined the surgical approaches we used to resect 22 parapharyngeal space tumours. In order to determine the best surgical approach for each tumour, we first subdivided the parapharyngeal space into six compartments, based on anatomical landmarks seen on computed tomography and/or magnetic resonance imaging scans. We then determined the location of each tumour relative to these six parapharyngeal space compartments. In our series of cases, we found that large tumours spanning the superior portion of the parapharyngeal space could be completely removed through a skull base approach. To remove a large tumour in the middle and inferior portion of the parapharyngeal space, a transparotid approach was the most suitable. Finally, a tumour in the inferior portion of the parapharyngeal space was best accessed through a transcervical approach.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Som, PM, Biller, HF, Lawson, W. Tumors of the parapharyngeal space: preoperative evaluation, diagnosis and surgical approaches. Ann Otol Rhinol Laryngol Suppl 1981;90:315CrossRefGoogle ScholarPubMed
2 Miller, FR, Wanamaker, JR, Lavertu, P, Wood, BG. Magnetic resonance imaging and the management of parapharyngeal space tumors. Head Neck 1996;18:67773.0.CO;2-X>CrossRefGoogle ScholarPubMed
3 Stell, PM, Mansfield, AO, Stoney, PJ. Surgical approaches to tumors of the parapharyngeal space. Am J Otolaryngol 1985;6:92–7CrossRefGoogle ScholarPubMed
4 Goodwin, WJ Jr, Chandler, JR. Transoral excision of lateral parapharyngeal space tumors presenting intraorally. Laryngoscope 1988;98:266–9CrossRefGoogle ScholarPubMed
5 Allison, RS, Van der Waal, I, Snow, GB. Parapharyngeal tumours: a review of 23 cases. Clin Otolaryngol Allied Sci 1989;14:199203CrossRefGoogle ScholarPubMed
6 Hughes, KV 3rd, Olsen, KD, McCaffrey, TV. Parapharyngeal space neoplasms. Head Neck 1995;17:124–30CrossRefGoogle ScholarPubMed
7 Malone, JP, Agrawal, A, Schuller, DE. Safety and efficacy of transcervical resection of parapharyngeal space neoplasms. Ann Otol Rhinol Laryngol 2001;110:1093–8CrossRefGoogle ScholarPubMed
8 Work, WP. Parapharyngeal space and salivary gland neoplasms. Otolaryngol Clin North Am 1977;10:421–6CrossRefGoogle ScholarPubMed
9 Batsakis, JG, Sneige, N. Parapharyngeal and retropharyngeal space diseases. Ann Otol Rhinol Laryngol 1989;98:320–1CrossRefGoogle ScholarPubMed
10 Kletzker, GR, Smith, PG, Bigelow, DC, Leonetti, JP, Grubb, RL. Management of high parapharyngeal space tumors. Ear Nose Throat J 1991;70:639–47Google ScholarPubMed
11 Carrau, RL, Johnson, JT, Myers, EN. Management of tumors of the parapharyngeal space. Oncology (Williston Park) 1997;11:633–40, 640, 642Google ScholarPubMed
12 Ducic, Y, Oxford, L, Pontius, AT. Transoral approach to the superomedial parapharyngeal space. Otolaryngol Head Neck Surg 2006;134:466–70CrossRefGoogle Scholar
13 Cummings, BJ. Juvenile nasopharyngeal angiofibroma: control rates and treatment costs. Head Neck Surg 1980;3:169–70CrossRefGoogle ScholarPubMed
14 Paris, J, Guelfucci, B, Moulin, G, Zanaret, M, Triglia, JM. Diagnosis and treatment of juvenile nasopharyngeal angiofibroma. Eur Arch Otorhinolaryngol 2001;258:120–4CrossRefGoogle ScholarPubMed