Parapharyngeal space tumor surgery using a modified cervical–parotid approach

Abstract

Objectives: The cervical approach to parapharyngeal space tumors is blind in cases involving an approach to the vicinity of the skull base from below. We therefore devised a procedure to improve the safety of surgery in the vicinity of the skull base.

Methods: With this surgical technique, the temporal branch from the main trunk is first identified, as in the case of parotid gland tumor surgery. We then approach the skull base by entering the posterior aspect of the parotid gland tissue from above the temporal branch and anterior auricular space, allowing clear visual confirmation of the upper part of the tumor. Combining this approach with the conventional cervical approach, which is used for the lower part, the tumor can be separated from top to bottom.

Results: We have applied this combined approach in eight patients to date, and post-operative courses have been good, with no cases of facial paralysis.

Conclusion: This modified cervical–parotid approach offers a very useful surgical procedure for parapharyngeal space tumors with respect to preservation of the facial nerve and tumor separation in the vicinity of the skull base.

Chinese abstract

目的：在从下方接近颅底区的情况下, 咽旁间隙肿瘤的颈部法是盲目的。因此, 我们设计了一个改善颅底区手术安全性的程序。

方法：采用这种手术技术, 首先确定从主干分出的颞叶, 就跟腮腺肿瘤手术的情况一样。然后我们通过从颞叶分支和前耳廓空间的上方进入腮腺组织的后方, 然后进入颅底, 从而可以对肿瘤上部有清晰的视觉确认。将这种方法与用于下部的常规颈部法结合, 可以从上到下分离肿瘤。

结果：迄今为止, 我们将这种联合方法应用于8位患者, 术后进程良好, 无面部麻痹。

结论：这种改进后的颈骶部手术为咽旁间隙肿瘤提供了非常有用的外科手术, 有利于面神经保护和颅底附近的肿瘤分离。

Keywords:

• Parapharyngeal space tumor
• pleomorphic adenoma
• modified cervical–parotid approach

Disclosure statement

No potential conflict of interest was reported by the authors.