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Volume 67, Issue 6, Pages 1239-1244 (June 2009)


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Management of Parapharyngeal-Space Tumors

Keqian Zhi, DDS, MDCorresponding Author Informationemail address, Wenhao Ren, DDS, Hong Zhou, DDS, Yumin Wen, DDS§, Yincheng Zhang, DDS

Purpose

This study evaluated parapharyngeal-space (PPS) tumors in regard to clinical pathological features, preoperative assessment, surgical approaches, perioperative complications, and patterns of recurrence.

Patients and Methods

We performed a retrospective review of patients with PPS tumors referred to the stomatological hospitals of Sichuan University and Xi'an Jiaotong University between 1990 and 2004.

Results

Beginning in 1990 and ending in 2004, 162 patients with PPS tumors were evaluated in our unit. The gender distribution was 94 (58.08%) males and 68 (41.98%) females. The median age was 36.4 years. The main presenting symptom was neck swelling. All cases were evaluated with at least a computed tomography scan. The most common class of lesion was salivary-gland neoplasm, accounting for 74 cases (45.68%). The next most common group of tumors was neurogenic, representing 68 cases (41.98%). Only 22 patients (13.58%) presented with malignant disease. Three surgical approaches were commonly used in the management of these lesions: transcervical-transparotid in 93 patients (57.41%), transcervical in 51 patients (31.48%), and transcervical-transmandibular in 18 patients (11.11%). Twenty patients with malignant disease underwent adjuvant chemotherapy and/or radiotherapy. All cases were followed for a mean of 36 months. There was no perioperative mortality. Two patients suffered local failure, and 4 patients developed distant metastasis during the observation period.

Conclusions

Surgery is the mainstay treatment for PPS tumors. Surgical approaches were dictated by size of the tumor, its location, its relationship to the great vessels, and suspicion of malignancy. The most common approach was transcervical-transparotid for benign tumors.

 Assistant Professor, Department of Oral and Maxillofacial Surgery/Oncologic Head and Neck Surgery, Stomatological Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi, China

 Resident, Department of Oral and Maxillofacial Surgery/Oncologic Head and Neck Surgery, Stomatological Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi, China

 Professor, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaan Xi, China

§ Professor, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, Sichuan, China

 Professor, Department of Oral and Maxillofacial Surgery/Oncologic Head and Neck Surgery, Stomatological Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi, China

Corresponding Author InformationAddress correspondence and reprint requests to Dr Zhi: Department of Oral and Maxillofacial Surgery/Oncologic Head and Neck Surgery, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaan Xi 710004, China

 This research received scientific funds from Xi'an City (SF08008-4) and educational funds of Stomatological Hospital in Xi'an Jiaotong University (2008-5).

PII: S0278-2391(08)01472-9

doi:10.1016/j.joms.2008.09.003


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