gms | German Medical Science

78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2007, Munich

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Transoral and combined transoral-transcervical approach to the parapharyngeal space tumors

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  • corresponding author Martin Chovanec - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic
  • Jan Betka - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic
  • Miloš Taudy - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic
  • Jan Plzák - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic
  • Daniela Kodetová - Institute of Pathology and Molecular Medicine, 2nd Medical Faculty, Charles Univ, Prague, Czech Republic
  • Jiří Lisý - Dep. of Radiodiagnostics, 2nd Medical Faculty, Charles University, Prague, Czech Republic

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 78. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. München, 16.-20.05.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07hnod127

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hnod2007/07hnod127.shtml

Published: April 24, 2007

© 2007 Chovanec et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objectives: To present our experience with transoral and combined transoral-transcervical approaches to the parapharyngeal space (PPS) tumors

Methods: Consequtive series of senior author (J.B.). 25 patients with various PPS tumors were retrospectively reviewed for type of tumor, size, previous treatment, approach, success of removal, length of hospitalization, complications and further treatment.

Results: Both approaches were safely employed to remove selected cases of PPS tumors. The most common pathology encountered were benign salivary gland tumors (12 minor salivary gland and 6 deep lobe parotid gland pleomorphic adenomas). 2 cases of malignant salivary gland tumors, four nerve sheath tumors and one lymphangioma were also excised. Visualization was felt to be satisfactory and dissection safe. Radical resection was achieved in 22 cases. Near total resection was achieved in 3 cases where otherwise other approach would be suitable but not undergone because of patient refusal and comorbidities. Patients with malignant tumors had postoperative radiotherapy. Radically operated cases are disease free. One of near-totally resected tumors needed revision surgery. Neither major complications nor disordered healing were encountered. Shortened hospitalization and minimalized morbidity were encountered.

Conclusion: Transoral approach safely provides access to selected cases (well surrounded, benign, non-hypervascular, non-dumbbell shaped) of PPS tumors based on preoperative imaging and fine needle aspiration cytology. Risk of nonradicality is acceptable. It can be combined with external approach to achieve safe resection of some benign tumors which would need transmandibular approach.