ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
kulak burun boğaz
ve baş boyun cerrahisi dergisi
http://dergi.kbb-bbc.org.tr
Kayıtlı İndeksler





ORIGINAL RESEARCH

Clinical Analysis and Surgical Management of 30 Cases with Parapharyngeal Space Tumor
Parafarengeal Boşluk Tümörlü 30 Vakanın Klinik Analizi ve Cerrahi Yönetimi
Received Date : 17 Jun 2020
Accepted Date : 18 Oct 2020
Available Online : 11 Feb 2020
Doi: 10.24179/kbbbbc.2020-77407 - Makale Dili: EN
KBB ve BBC Dergisi. 2021;29(1):33-8
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The aim of this study was to evaluate our 10- year experience in the treatment of parapharyngeal space (PPS) tumors in our clinic using current diagnosis and treatment methods, present our surgical approaches, and compare our findings with the literature. Material and Methods: We retrospectively analyzed the medical records of all patients in a single clinic who had a mass in the PPS between 2008 and 2018. We recorded and analyzed PPS mass histologic features, surgical approaches, complications that occurred before and after surgery, and surgical outcomes. Results: Thirty patients were included in the study; 50% of the patients were female, and 50% were male. In the diagnosis phase, contrasted computed tomography and magnetic resonance imaging were used. Fine needle aspiration cytology was performed in all patients, and all patients underwent surgery in this series. The transparotid approach was the most commonly used surgical technique, followed by the transcervical- submandibular, transcervical-transparotid, and transparotidtransmastoid combined approaches. Complications were seen in 17 of 30 (53%) patients. The mean follow-up period was 32 months, with a range of 24-54 months. Four patients were lost to follow-up, and the tumors of 26 patients did not relapse. Conclusion: PPS tumors are rare, but a good strategy for their management must be formed before surgery. By performing surgery with the most appropriate surgical technique and imaging tests, surgeons can minimize potential complications.
ÖZET
Amaç: Bu çalışmanın amacı, kliniğimizde parafarengeal boşluk (PFB) tümörlerinin tedavisinde 10 yıllık tecrübemizi güncel tanı ve tedavi yöntemleri ile değerlendirmek, cerrahi yaklaşımlarımızı sunmak ve literatürle karşılaştırmaktır. Gereç ve Yöntemler: 2008- 2018 yılları arasında, PFB’de kitle bulunan tüm hastaların tıbbi kayıtları tek bir klinikte retrospektif olarak incelendi. PFB kitlelerinin; histolojik özellikleri, bölgeye cerrahi yaklaşımlar, ameliyat öncesi ve sonrası oluşan komplikasyonlar ve cerrahi sonuçlar kaydedilerek analiz edildi. Bulgular: Çalışmaya 30 hasta dâhil edildi, hastaların %50’si kadın %50’si erkekti. Tanı aşamasında, kontrastlı bilgisayarlı tomografi ve manyetik rezonans görüntüleme kullanıldı. Tüm hastalara ince iğne aspirasyon sitolojisi uygulandı. Bu seride, tüm hastalar ameliyat edildi. En sık kullanılan cerrahi teknik transparotid yaklaşımdı, ardından sırasıyla; transservikal-submandibuler, transservikal- transparotid ve transparotid-transmastoid kombine yaklaşım geldi. Otuz hastanın 17 (%53)’sinde komplikasyon görüldü. Takip süresi 24-52 ay arasında değişirken, ortalama 32 ay olarak saptanırken, 4 hastanın takibine devam edilemedi ve 26 hastada ise nüks gözlenmedi. Sonuç: PFB tümörleri nadir olmakla birlikte, ameliyattan önce iyi bir planlama yapılmalıdır. Görüntüleme testleri ve sonuçları ile olası komplikasyonları en aza indirecek uygun cerrahi teknik ile tedavi sağlanır.
KAYNAKLAR
  1. Locketz GD, Horowitz G, Abu-Ghanem S, Wasserzug O, Abergel A, Yehuda M, et al. Histopathologic classification of parapharyngeal space tumors: a case series and review of the literature. Eur Arch Otorhinolaryngol. 2016;273(3):727-34.[Crossref] [PubMed] 
  2. Shahab R, Heliwell T, Jones AS. How we do it: a series of 114 primary pharyngeal space neoplasms. Clin Otolaryngol. 2005;30(4):364-7.[Crossref] [PubMed] 
  3. Kuet ML, Kasbekar AV, Masterson L, Jani P. Management of tumors arising from the parapharyngeal space: a systematic review of 1,293 cases reported over 25 years. Laryngoscope. 2015;125(6):1372-81.[Crossref] [PubMed] 
  4. Cohen SM, Burkey BB, Netterville JL. Surgical management of parapharyngeal space masses. Head Neck. 2005;27(8):669-75.[Crossref] [PubMed] 
  5. Kazkayası M, Arıkan O K, Dikici O. [Approach to parapharyngeal masses]. KBB ve BBC Dergisi. 2008;16(2):87-92.[Link] 
  6. Özcan M, Tuncel Ü, Ünal A, Arda N, Yalçın F. [Transcervical- transmandibular approach for parapharyngeal masses: report of four cases]. KBB-Forum. 2002;1(2):48-53.[Link] 
  7. Chen H, Sun G, Tang E, Hu Q. Surgical treatment of primary parapharyngeal space tumors: a single-institution review of 28 cases. J Oral Maxillofac Surg. 2019;77(7):1520.e1-e16.[Crossref] [PubMed] 
  8. Cassoni A, Terenzi V, Della Monaca M, Bartoli D, Battisti A, Rajabtork Zadeh O, et al. Parapharyngeal space benign tumours: our experience. J Craniomaxillofac Surg. 2014;42(2):101-5.[Crossref] [PubMed] 
  9. López F, Suárez C, Vander Poorten V, Mäkitie A, Nixon IJ, Strojan P, et al. Contemporary management of primary parapharyngeal space tumors. Head Neck. 2019;41(2):522-35.[Crossref] [PubMed] 
  10. Bradley PJ, Bradley PT, Olsen KD. Update on the management of parapharyngeal tumours. Curr Opin Otolaryngol Head Neck Surg. 2011;19(2):92-8.[Crossref] [PubMed] 
  11. Infante-Cossio P, Gonzalez-Cardero E, Gonzalez-Perez LM, Leopoldo-Rodado M, Garcia-Perla A, Esteban F, et al. Management of parapharyngeal giant pleomorphic adenoma. Oral Maxillofac Surg. 2011;15(4):211-6.[Crossref] [PubMed] 
  12. Prasad SC, Piccirillo E, Chovanec M, La Melia C, De Donato G, Sanna M, et al. Lateral skull base approaches in the management of benign parapharyngeal space tumors. Auris Nasus Larynx. 2015;42(3):189-98.[Crossref] [PubMed] 
  13. Olsen KD. Tumors and surgery of the parapharyngeal space. Laryngoscope. 1994;104(5 Pt 2 Suppl 63):1-28.[Crossref] [PubMed] 
  14. Riffat F, Dwivedi RC, Palme C, Fish B, Jani P. A systematic review of 1143 parapharyngeal space tumors reported over 20 years. Oral Oncol. 2014;50(5):421-30.[Crossref] [PubMed] 
  15. Ijichi K, Murakami S. Surgical treatment of parapharyngeal space tumors: a report of 29 cases. Oncol Lett. 2017;14(3):3249-54.[Crossref] [PubMed] [PMC] 
  16. Lao WP, Han PS, Lee NH, Gilde JE, Inman JC. Transoral excision of parapharyngeal tumors. Ear Nose Throat J. 2020;19.[Crossref] [PubMed] 
  17. Maglione MG, Guida A, Pavone E, Longo F, Aversa C, Villano S, et al. Transoral robotic surgery of parapharyngeal space tumours: a series of four cases. Int J Oral Maxillofac Surg. 2018;47(8):971-5.[Crossref] [PubMed] 
  18. Chu F, Tagliabue M, Giugliano G, Calabrese L, Preda L, Ansarin M, et al. From transmandibular to transoral robotic approach for parapharyngeal space tumors. Am J Otolaryngol. 2017;38(4):375-9.[Crossref] [PubMed]