Management of parapharyngeal-space tumors.
OBJECTIVE
This study evaluated parapharyngeal-space (PPS) tumors in regard to clinical pathological features, preoperative assessment, surgical approaches, perioperative complications, and patterns of recurrence.


METHODS
We performed a retrospective review of patients with PPS tumors referred to the stomatological hospitals of Sichuan University and Xi'an Jiaotong University between 1990 and 2004.


RESULTS
Beginning in 1990 and ending in 2004, 162 patients with PPS tumors were evaluated in our unit. The gender distribution was 94 (58.08%) males and 68 (41.98%) females. The median age was 36.4 years. The main presenting symptom was neck swelling. All cases were evaluated with at least a computed tomography scan. The most common class of lesion was salivary-gland neoplasm, accounting for 74 cases (45.68%). The next most common group of tumors was neurogenic, representing 68 cases (41.98%). Only 22 patients (13.58%) presented with malignant disease. Three surgical approaches were commonly used in the management of these lesions: transcervical-transparotid in 93 patients (57.41%), transcervical in 51 patients (31.48%), and transcervical-transmandibular in 18 patients (11.11%). Twenty patients with malignant disease underwent adjuvant chemotherapy and/or radiotherapy. All cases were followed for a mean of 36 months. There was no perioperative mortality. Two patients suffered local failure, and 4 patients developed distant metastasis during the observation period.


CONCLUSIONS
Surgery is the mainstay treatment for PPS tumors. Surgical approaches were dictated by size of the tumor, its location, its relationship to the great vessels, and suspicion of malignancy. The most common approach was transcervical-transparotid for benign tumors.
Zhi
Keqian
K
Department of Oral and Maxillofacial Surgery/Oncologic Head and Neck Surgery, Stomatological Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi, China. zhikeqian@sina.com
Ren
Wenhao
W
Zhou
Hong
H
Wen
Yumin
Y
Zhang
Yincheng
Y
D008949:Adenoma, Pleomorphic / Q000601:surgery; D000328:Adult; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000556:secondary / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003389:Cranial Nerve Diseases / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009334:Neck Muscles / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010306:Parotid Gland / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000601:surgery; D014057:Tomography, X-Ray Computed