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Resection of Parapharyngeal Space Tumors Located in the Prestyloid Compartment: Efficacy of the Cervical Approach

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Parapharyngeal space tumors are rare. Among them, tumors in the prestyloid compartment are particularly suitable for surgery; however, there are no detailed reports of such surgery and their features remain unknown.

Methods

We conducted a retrospective cohort study. For 67 surgical cases of benign tumors in this compartment, we examined the patient and tumor characteristics, fine-needle aspiration cytology (FNAC), and intraoperative details such as surgical approach, use of complete excision, and postoperative complications.

Results

Pleomorphic adenomas (PAs) comprised 73.1% of the lesions. The diagnostic accuracy of FNAC to differentiate benign and malignant tumors was 97.7%. Of the treated lesions, 94.0% were removed via the cervical approach alone, including all PAs. The remaining 6.0% were resected via the cervical–parotid approach. The median operative time and bleeding volume were 89 min and 50 mL, respectively. Operative time using the cervical approach was significantly shorter (p = 0.021). All cases could be treated via complete surgical excision. Postoperative complications occurred in 32.8% of patients, with transient slight facial palsy being the most common. No fatal complications occurred and 92.5% of patients had no sequelae. There was no significant association between complications and surgical approach.

Conclusion

Based on diagnosis by FNAC, with a high accuracy rate, most benign prestyloid tumors, especially PAs, were resected using the cervical approach alone, with a shorter operative time and without severe complications.

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References

  1. Lopez F, Suarez C, Vander Poorten V, et al. Contemporary management of primary parapharyngeal space tumors. Head Neck 2019;41(2): 522–535.

    PubMed  Google Scholar 

  2. Olsen KD. Tumors and surgery of the parapharyngeal space. Laryngoscope 1994;104(5 Pt 2 Suppl 63):1–28.

  3. Shirakura S, Tsunoda A, Akita K, et al. Parapharyngeal space tumors: anatomical and image analysis findings. Auris Nasus Larynx 2010;37(5): 621–625.

    Article  Google Scholar 

  4. Shahab R, Heliwell T, Jones AS. How we do it: a series of 114 primary pharyngeal space neoplasms. Clin Otolaryngol. 2005;30(4): 364–367.

    Article  CAS  Google Scholar 

  5. Riffat F, Dwivedi RC, Palme C, Fish B, Jani P. A systematic review of 1143 parapharyngeal space tumors reported over 20 years. Oral Oncol. 2014;50(5): 421–430.

    Article  Google Scholar 

  6. Locketz GD, Horowitz G, Abu-Ghanem S, et al. Histopathologic classification of parapharyngeal space tumors: a case series and review of the literature. Eur Arch Otorhinolaryngol. 2016;273(3): 727–734.

    Article  Google Scholar 

  7. Kuet ML, Kasbekar AV, Masterson L, Jani P. Management of tumors arising from the parapharyngeal space: a systematic review of 1,293 cases reported over 25 years. Laryngoscope. 2015;125(6):1372–1381.

    Article  Google Scholar 

  8. Okamoto I, Tsukahara K, Sato H. Parapharyngeal space tumor surgery using a modified cervical-parotid approach. Acta Otolaryngol. 2018;138(2): 165–169.

    Article  Google Scholar 

  9. Pang KP, Goh CH, Tan HM. Parapharyngeal space tumours: an 18 year review. J Laryngol Otol. 2002;116(3): 170–175.

    Article  Google Scholar 

  10. Matsuki T, Miura K, Tada Y, et al. Classification of tumors by imaging diagnosis and preoperative fine-needle aspiration cytology in 120 patients with tumors in the parapharyngeal space. Head Neck 2019;41(5): 1277–1281.

    Article  Google Scholar 

  11. Vallabhaneni AC, Mandakulutur SG, Vallabhaneni S, Prabha A, Banavara RK. True parapharyngeal space tumors: case series from a teaching oncology center. Indian J Otolaryngol Head Neck Surg. 2017;69(2): 225–229.

    Article  Google Scholar 

  12. Nagamine WH, Conneely MF, Petruzzelli GJ, Hacein-Bey L. Glossopharyngeal schwannoma of the suprahyoid carotid space: case report and discussion of the relationship to the carotid artery. Laryngoscope 2009;119(4): 653–656.

    Article  Google Scholar 

  13. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone marrow transplant. 2013;48(3): 452–458.

    Article  CAS  Google Scholar 

  14. Som PM, Biller HF, Lawson W. Tumors of the parapharyngeal space: preoperative evaluation, diagnosis and surgical approaches. Ann Otol Rhinol Laryngol Suppl. 1981;90(1 Pt 4): 3–15.

    Article  CAS  Google Scholar 

  15. Chen WL, Wang YY, Zhang DM, Huang ZQ. Endoscopy-assisted transoral resection of large benign parapharyngeal space tumors. Br J Oral Maxillofac Surg. 2014;52(10): 970–973.

    Article  Google Scholar 

  16. Iseri M, Ozturk M, Kara A, Ucar S, Aydin O, Keskin G. Endoscope-assisted transoral approach to parapharyngeal space tumors. Head Neck 2015;37(2): 243–248.

    Article  Google Scholar 

  17. Boyce BJ, Curry JM, Luginbuhl A, Cognetti DM. Transoral robotic approach to parapharyngeal space tumors: case series and technical limitations. Laryngoscope 2016;126(8):1776–1782.

    Article  Google Scholar 

  18. Chan JY, Tsang RK, Eisele DW, Richmon JD. Transoral robotic surgery of the parapharyngeal space: a case series and systematic review. Head Neck 2015;37(2): 293–298.

    Article  Google Scholar 

  19. Ijichi K, Murakami S. Surgical treatment of parapharyngeal space tumors: a report of 29 cases. Oncol Lett. 2017;14(3): 3249–3254.

    Article  Google Scholar 

  20. Shin JH, Lee HK, Kim SY, Choi CG, Suh DC. Imaging of parapharyngeal space lesions: focus on the prestyloid compartment. Am J Roentgenol. 2001;177(6): 1465–1470.

    Article  CAS  Google Scholar 

  21. Varoquaux A, Fakhry N, Gabriel S, et al. Retrostyloid parapharyngeal space tumors: a clinician and imaging perspective. Eur J Radiol. 2013;82(5):773–782.

    Article  CAS  Google Scholar 

  22. Sato Y, Imanishi Y, Tomita T, et al. Clinical diagnosis and treatment outcomes for parapharyngeal space schwannomas: a single-institution review of 21 cases. Head Neck. 2018;40(3):569–576.

    Article  Google Scholar 

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Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan

    Takashi Matsuki MD, PhD, Yuichiro Tada MD, PhD, Tatsuo Masubuchi MD, PhD, Chihiro Fushimi DDS, PhD, Shinetsu Kamata MD, PhD & Kouki Miura MD, PhD

  2. Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Takashi Matsuki MD, PhD, Shunsuke Miyamoto MD, PhD & Taku Yamashita MD, PhD

  3. Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University School of Medicine, Tokyo, Japan

    Isaku Okamoto MD, PhD

Authors
  1. Takashi Matsuki MD, PhD
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  2. Isaku Okamoto MD, PhD
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  3. Yuichiro Tada MD, PhD
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  4. Tatsuo Masubuchi MD, PhD
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  5. Chihiro Fushimi DDS, PhD
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  6. Shinetsu Kamata MD, PhD
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  7. Shunsuke Miyamoto MD, PhD
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  8. Taku Yamashita MD, PhD
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  9. Kouki Miura MD, PhD
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Contributions

TM Conceptualization, study design, acquisition and analysis of data, writing the original draft. IO Study design, acquisition of data. YT Acquisition and analysis of data. TM Acquisition of data. CF Acquisition of data. SK Supervision, and acquisition of data. SM Interpretation of data. TY Interpretation of data. KM Supervision, and acquisition of data. All authors contributed to the writing of the final manuscript and approved the manuscript to be published. They agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Takashi Matsuki MD, PhD.

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Disclosures

Takashi Matsuki, Isaku Okamoto, Yuichiro Tada, Tatsuo Masubuchi, Chihiro Fushimi, Shinetsu Kamata, Shunsuke Miyamoto, Taku Yamashita, and Kouki Miura declare no conflicts of interest.

Ethics Approval

This study was approved by the Institutional Ethics Review Board of the International University of Health and Welfare, Mita Hospital (5-19-32). Regarding consent to participate, patients could decline to participate by opting out of an announcement on the institutions’ website. This study was conducted in accordance with the Declaration of Helsinki.

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Matsuki, T., Okamoto, I., Tada, Y. et al. Resection of Parapharyngeal Space Tumors Located in the Prestyloid Compartment: Efficacy of the Cervical Approach. Ann Surg Oncol 28, 3066–3072 (2021). https://doi.org/10.1245/s10434-020-09268-x

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  • DOI: https://doi.org/10.1245/s10434-020-09268-x

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