CASE REPORT   

Minerva Stomatologica 1999 July-August;48(7-8):333-40

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Surgical approaches to tumors of the para-pharyngeal space

Belli E., Cicconetti A., Matteini C., Rivaroli A.

Surgical access to tumors of the parapharyngeal space can be performed by transoral or trancervical approaches. Risk of intraoperative bleeding and difficulties in radical enucleation represent the disadvantages of trans-oral approach. This approach must be performed for small and inferomedial lesions, or for preoperative biopsy when necessary. Transcervical approaches can be distinguished in transparotid or transmandibular, or submandibular. Before the late '70s all parapharyngeal masses were approached by transparotid access, with facial nerve manipulation in all cases. CT and MR techniques now allow the right presumptive preoperative diagnosis in 90% of patients. To avoid the risk of injury of the facial nerve when possible, transparotid approach is now limited to the lesions with parotid origin. Transmandibular and submandibular approaches allow an adequate exposure and a direct access to the parapharyngeal space. Personal experience with 6 patients presenting primitive tumors of the parapharyngeal space is reported and surgical approaches proposed in the literature are reviewed.