title: A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland.
abstract: The management of parapharyngeal tumor is surgical, but the approach remains a challenge. Attention should be paid to avoidance intra-operative bleeding or cranial nerves damage. We report a case of a 67-year-old male complaining of left-ear fullness. A submucosal mass arising from the lateral wall of oropharynx on the left side was observed. Magnetic resonance imaging detected a mass arising from the parotid gland, in particular from the deep lobe, and a fine needle biopsy was compatible with "Warthin tumor." We performed a mini-invasive transoral approach under magnification, previous isolation of homolateral vessels. The decision on which surgical approach to be used is determined by site, size vascularity, and histology of the tumor. A literature review of the main surgical approaches was performed. We performed a combined transoral dissection under magnification with cervicotomic exposure of the neck vascular bundle allowing to dissect the tumor and manage any intra-operative complications.
authors.affiliation: Facolta di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, Roma, Italy.
authors.forename: Manuele
authors.initials: M
authors.lastname: Casale
authors.affiliation: Facolta di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, Roma, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Capuano
authors.affiliation: Facolta di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, Roma, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Sabatino
authors.affiliation: Facolta di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, Roma, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pace
authors.affiliation: Facolta di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, Roma, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Oliveto
authors.affiliation: Facolta di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, Roma, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Vella
authors.affiliation: Facolta di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, Roma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Moffa
authors.affiliation: Facolta di Medicina e Chirurgia, Università Campus Bio-Medico di Roma, Roma, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Salvinelli
keywords: Parapharyngeal mass; Warthin tumor; cervical resection; transoral resection