Surgical Approaches and Postoperative Complcations of Parapharyngeal Space Tumours

Abstract

SummaryIntroduction.Parapharyngeal space (PPS) tumors are rare neoplasms that are greatly varying both clinically and morphologically. Complete tumor removal from the PPS requires an integrated approach to resection of nervous and vascular trunks and hemorrhage control.Aim of the Study.This study aimed evaluation of surgical interventions applied for PPS neoplasms along with revision of postoperative complications noticed conducting these surgeries.Material and Methods.32 PPS tumors removed during surgeries as well as associated biopsies performed at Riga East University Hospital Oncology Center of Latvia at the Department of Head and Neck Surgery from 01.01.2001 till 31.12.2006 were included in this study.Results.The largest number of patients presented with benign salivary gland tumors 22 (68.7%), followed by malignant salivary gland neoplasms 5 (18.5%), neurogenic tumors 4 (12.5%), and miscellaneous tumors 1 (0.3%). Postoperative complications for malignant salivary gland surgeries occurred at the highest rate (42%), whereas, for benign - at the lowest (5%). Transcervical - submandibular, transparotid, and transoral approach was used in 56, 25, and 1% of surgeries, accordingly, whereas, mandibulotomy applied in 17%. “First bite syndrome” was noticed in 30% of the cases, cranial nerve palsies - in 20%, temporary, permanent facial nerve and accessorial nerve injury in 4, 1 and 15% of surgical interventions, accordingly. Vascular trunks damage occurred at 9%, and, mostly, for poststyloid lesions.Conclusions.Heterogeneous PPS tumors show a wide spectrum of postoperative complications and require a selective approach for optimization of surgical intervention and treatment strategy.