Trans-oral approach and trans-cervical approach in resection of parapharyngeal space tumors: a comparative analysis

Abstract

Objective To investigate the operative methods for benign tumors in parapharyngeal space. Methods The clinical data from 48 patients with benign tumors in parapharyngeal space admitted to Otolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University from February 2013 to February 2018 were retrospectively analyzed. All patients underwent imaging examination before surgery. Thirty-two cases of parapharyngeal space tumors were resected by trans-cervical approach and 16 cases by trans-oral approach. The therapeutic effects of the two methods were compared. Results Pathological results showed 20 cases (41.7%) of schwannoma, 17 cases (35.4%) of pleomorphic adenoma, 4 cases (8.3%) of neurofibroma, 4 cases (8.3%) of hemangioma and 3 cases (6.3%) of cyst. During hospitalization, 6 cases who were given trans-cervical approach surgery had complications, and 2 cases treated by trans-oral approach surgery had complications. Postoperative follow-up ranged from 10 to 62 months. Two cases treated by trans-oral approach recurred, and 3 cases treated by trans-cervical approach recurred. All of the 5 patients were cured by performing operation again. Statistical analysis showed that there was no significant difference in gender, age, length of hospital stay, incidence of complications during hospitalization or recurrence between the two surgery approaches (P>0.05); however, there was a significant difference in operation duration and intraoperative bleeding between the two approaches (P<0.05). Conclusions The trans-oral approach is a better surgical method for tumors located in the anterior half of parapharyngeal space, while trans-cervical approach is recommended to neurogenic tumors located in the posterior half of parapharyngeal space. Key words: Parapharyngeal space neoplasms; Trans-cervical approach; Trans-oral approach