title: Parapharyngeal space tumors without mandibulotomy: our experience.
abstract: Parapharyngeal space (PPS) tumors are rare and benign in 80% of cases. Since surgeons first resected this anatomical region, the surgical approach to PPS bulks has been a hot topic due to their shape and the important structures involved. We present a series of patients treated with a transcervical or transcervical-transparotid approach to benign PPS tumors without mandibulotomy. Between May 2003 and March 2009, 18 patients (11 male and 7 female) with benign PPS tumors underwent a surgical resection, avoiding mandibulotomy. Average age of the patients was 49 years (range 3-76), average tumor size was 5.5 × 4 × 3 cm and histological examination of the resected tumors showed: seven pleomorphic adenomas of the deep parotid lobe, four schwannomas, two mycobacteriosis, two paragangliomas of the vagus nerve, one lipoma, one neurofibroma and one cavernous hemangioma. Seven patients underwent a transcervical approach, while 11 patients underwent a transcervical-transparotid approach. Excision of benign PPS tumors is possible without mandibulotomy even in the case of a large tumor mass, but exposure with the mandible in situ is certainly poor. Avoiding mandibulotomy reduces patient morbidity and hospital stay. In our experience, mandibulotomy can be avoided in most cases of benign PPS tumors leaving this procedure for malignant tumors or in patients with very poor exposure.
authors: Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo 71, 41100 Modena, Italy.
authors: Livio
authors: L
authors: Presutti
authors: Gabriele
authors: G
authors: Molteni
authors: Laura
authors: L
authors: Malvè
authors: Daniele
authors: D
authors: Marchioni
authors: Angelo
authors: A
authors: Ghidini
authors: Sauro
authors: S
authors: Tassi
authors: Luigi
authors: L
authors: Chiarini
authors: Matteo
authors: M
authors: Alicandri-Ciufelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010614:Pharynx; D055815:Young Adult