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A Journal on Surgery

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Chirurgia 2010 June;23(3):75-9

language: English

Parapharyngeal schwannoma treated by rhytidectomy approach

Ottaviani F., Caviggioli F., Villani F., Klinger F.

1 Dipartimento di Scienze Cliniche “L. Sacco”, Università degli Studi di Milano, Milano
2 Cattedra di Chirurgia Plastica, Università degli Studi di Milano, IRCCS Istituto Clinico Humanitas, U.O. Chirurgia Plastica 2, Rozzano, Milano


Parapharyngeal neoplasms are rare (0.5% of all head and neck tumours) and about 17%-30% of them are neurogenic tumors. Neurilemmoma (or benign schwannoma) is the most common parapharyngeal neurogenic tumor. We are proposing an aesthetic surgical approach. A 61-year-old woman presented with painless swelling of the parotid region. We performed lateral parotidectomy through rhytidectomy incision. We excised an encapsulated, 4,3 x 2,2 x 1,8 cm-sized neurilemmoma, involving the post-styloid compartment of the parapharyngeal space. Post-operative transient monolateral inferior lip palsy occured. After 2-year follow up, aesthetic results were satisfactory. The mainstay of PPS tumors treatment is surgical excision. Transoral, transcervical, transparotid, mandibulotomy, infratemporal, transcervical-transmastoid approaches and their combinations have been proposed: their advantages, disavantages and indications are being discussed and the literature is being overviewed.

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