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OBJECTIVE To explore the diagnosis and reasonable surgical approach for parapharyngeal space neoplasms. METHODS From July 2004 to July 2009, a retrospective review of 45 patients with neoplasms of parapharyngeal space was performed. Fourty-five cases were examined by CT, some of them were examined by MRI or DSA. Several surgical approaches were selected. The transcervical approach was used in 35 cases, the transparotid approach was used in 5 cases, the transmandible approach was used in 2 cases, and the transparotid and temporal approach was used in 3 cases. RESULTS Among 45 patients, 37 cases (82.22%) were benign and 8 cases (17.78%) were malignant. Neurogenic neoplasms and salivary glands neoplasms were the most common tumors. Using CT, MRI or DSA could obtain useful information about the location, size, shape, density and degree of enhancement of the parapharyngeal space neoplasms, acquire their relationship with styloid and carotid, and make preoperative diagnosis. The diagnostic coincidence rate between preoperative diagnosis and pathological diagnosis was 80% (origin of tissue). All benign tumors were completely resected. A lymphangiomas had recurrence after 1 year,and the second operation had no recurrence. In the 45 cases, 8 cases were malignant tumors. Of 2 patients with malignant mixed tumors, 1 survived disease free after a follow-up of 4 years,and another was still alive with disease after a follow-up of 3 years; Of 2 patients with synovial sarcomas, 1 survived disease free for a follow-up of 3 years, the other one survived disease free after a follow-up of 2 years; 1 patient of nasopharyngeal carcinoma with metastasis in the parapharyngeal space had post-operative radical radiotherapy and survived disease free after a follow-up of 5 years. One patient with chordoma was still alive with disease after a follow-up of 3 years; 1 patient with poorly differentiated squamous cell carcinoma, died of pulmonary metastasis after a 4 year follow-up; 1 case with follicular dendritic cell sarcoma survived disease free after a follow-up of 2 years. CONCLUSIONS CT, MRI and DSA are essential for the diagnosis and differentiation of parapharyngeal space neoplasm. The transcervical approach is a simple, safe and minimal invasive procedure for resecting parapharyngeal space neoplasms. It is the best approach for treatment of parapharyngeal space neoplasms.
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
October 2007,
Shanghai kou qiang yi xue = Shanghai journal of stomatology,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
August 1998,
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
May 2013,
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
June 1998,
Zhonghua er bi yan hou ke za zhi,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
January 1995,
Head & neck,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
February 2000,
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
January 2011,
Acta chirurgica Iugoslavica,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
December 2015,
The Indian journal of surgery,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
December 1987,
Ear, nose, & throat journal,
Jianzhong Sang, and
Weihua Lou, and
Yamin Zhang
July 2004,
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology,
