Endoscopy-Assisted Transoral Versus Endoscopy-Assisted Transcervical Minimal Incision Plus Mandibular Osteotomy Approach in Resection of Large Parapharyngeal Space Tumors.
BACKGROUND
Resection of the parapharyngeal space is often challenging. This study aims to evaluate the outcome of the endoscopy-assisted transoral approach for resection of the parapharyngeal space tumors compared with the endoscopy-assisted transcervical approach.


METHODS
Twenty-three consecutive patients (15 males, 8 females) who underwent resection of large parapharyngeal space tumors via endoscopy-assisted transoral (ETO) approach or endoscopy-assisted transcervical minimal incision plus osteotomy of the vertical ramus outside the mandibular foramen (ETC + MO) approach were analyzed retrospectively.


RESULTS
The tumors in ETO group are benign; there are 2 patients with adenoid cystic carcinoma and 1 patient with recurrent pleomorphic adenoma in ETC + MO group. All of the tumors were removed completely and without rupture. No major complications developed in any patient. Temporary facial paresis occurred in 1 patient in the ETC + MO group, which resolved spontaneously within 8 weeks. The cosmetic effects of all patients in ETO groups and 10 patients in ETC + MO groups were excellent. Patients were followed up for 7 to 26 months, no recurrence was encountered.


CONCLUSIONS
ETO and ETC + MO approach in resection of large parapharyngeal space tumors are feasible and safe technique that achieve excellent aesthetic and functional results. Endoscopy-assisted transoral approach can shorten hospitalized time and avoid the risk of marginal mandibular nerve injury and ETC + MO approach may be used in malignant or recurrent parapharyngeal space tumors.
Department of Oral and Maxillofacial Surgery, Sun Yet-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Wei-Liang
WL
Chen
Song
S
Fan
Zhi-Quan
ZQ
Huang
Da-Ming
DM
Zhang
D008949:Adenoma, Pleomorphic / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D063168:Mandibular Osteotomy / Q000379:methods*; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D010027:Osteotomy / Q000379:methods; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult