Endoscopy-Assisted Transoral Versus Endoscopy-Assisted Transcervical Minimal Incision Plus Mandibular Osteotomy Approach in Resection of Large Parapharyngeal Space Tumors

Abstract

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. 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. 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. 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.