Surgical Management of Parapharyngeal Tumors: Our Experience

Poonam Joshi; Kamal Deep Joshi; Sudhir Nair; Muddasir Bhati; Deepa Nair; Munita Bal; Amit Joshi; Naveen Mummudi; Vidisha Tuljapurkar; Devendra A. Chaukar; Pankaj Chaturvedi

doi:10.1055/s-0041-1731580

South Asian Journal of Cancer, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · South Asian J Cancer 2021; 10(03): 167-171
DOI: 10.1055/s-0041-1731580

Original Article: Head and Neck Cancer

Surgical Management of Parapharyngeal Tumors: Our Experience

Poonam Joshi

¹Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Kamal Deep Joshi

¹Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Sudhir Nair

¹Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Muddasir Bhati

¹Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Deepa Nair

¹Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Munita Bal

²Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Amit Joshi

³Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Naveen Mummudi

⁴Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Vidisha Tuljapurkar

¹Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Devendra A. Chaukar

¹Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Pankaj Chaturvedi

¹Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

› Institutsangaben

Abstract

Context Tumors of parapharyngeal space (PPS) are rare and histologically diverse. The management of these tumors requires diligent assessment and planning with due consideration of various anatomical and pathological aspects of the lesion.

Aims This retrospective study aims to present our experiences in the clinical and pathological aspects of PPS tumors with a critical evaluation of management.

Settings and Design Retrospective analytical study.

Methods and Material The electronic medical records of 60 cases of PPS tumors, managed surgically from 2007 to 2017, were reviewed and analyzed using SPSS 22 software. The mean follow-up duration was 44 months.

Results The mean age was 45 years with a male-to-female ratio of 1.7 (38:22). The majority of the tumors were benign (71.7%) and the most common presentation being upper neck mass or oropharyngeal mass. Histologically, neurogenic tumors were most common (43.3%) PPS tumors, followed by tumors of salivary gland origin. Magnetic resonance imaging was used as a diagnostic modality in 70% of cases, and computed tomography scan and positron emission tomography/CT were used in 26.7 and 3.3% of cases, respectively. In our study, the diagnostic accuracy of fine-needle aspiration cytology was 71% for benign and 47% for malignant lesions. The most common approach for surgery used was transcervical (72%).

Conclusion The study reveals that cranial nerve palsy is the most common complication associated with PPS tumors. Completely resected, malignant tumors originating within PPS have a good prognosis, as compared with tumors extending or metastasized to PPS.

Keywords

parapharyngeal space tumors - surgical approach - cranial nerve palsies - deep neck space tumors - schwannoma

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