Standardised method of selecting surgical approaches to benign parapharyngeal space tumours, based on pre-operative images.
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.
Kanzaki
S
S
Department of Otolaryngology, Head and Neck Surgery, Shizuoka Red Cross Hospital, Otteemachi Aoi, Shizuoka, Tokyo, Japan. skan@sc.itc.keio.ac.jp
Nameki
H
H
D008949:Adenoma, Pleomorphic / Q000473:pathology / Q000601:surgery; D000368:Aged; D018322:Angiofibroma / Q000473:pathology / Q000601:surgery; D003560:Cysts / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010307:Parotid Neoplasms / Q000473:pathology / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed