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Standardised method of selecting surgical approaches to benign parapharyngeal space tumours, based on pre-operative images

Published online by Cambridge University Press:  26 July 2007

S Kanzaki*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Shizuoka Red Cross Hospital, Otteemachi Aoi, Shizuoka, Tokyo, Japan Department of Otolaryngology, Keio University Medical School, Tokyo, Japan
H Nameki
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Shizuoka Red Cross Hospital, Otteemachi Aoi, Shizuoka, Tokyo, Japan
*
Address for correspondence: Dr Sho Kanzaki, Department of Otolaryngology, Keio University Medical School, 35 Shinanomachi, Shinjuku, Tokyo, Japan. E-mail: skan@sc.itc.keio.ac.jp

Abstract

Many approaches to the parapharyngeal space have been reported. However, few reports describe parapharyngeal space tumours and the best surgical approach to these tumours. We retrospectively examined the surgical approaches we used to resect 22 parapharyngeal space tumours. In order to determine the best surgical approach for each tumour, we first subdivided the parapharyngeal space into six compartments, based on anatomical landmarks seen on computed tomography and/or magnetic resonance imaging scans. We then determined the location of each tumour relative to these six parapharyngeal space compartments. In our series of cases, we found that large tumours spanning the superior portion of the parapharyngeal space could be completely removed through a skull base approach. To remove a large tumour in the middle and inferior portion of the parapharyngeal space, a transparotid approach was the most suitable. Finally, a tumour in the inferior portion of the parapharyngeal space was best accessed through a transcervical approach.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2007

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