International Journal of Head and Neck Surgery

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VOLUME 8 , ISSUE 1 ( January-March, 2017 ) > List of Articles

RESEARCH ARTICLE

A Clinical Approach to the Parapharyngeal Space

AM Shivakumar, Praveen D Shivanandappa, Veena P Doddamane, KS Munish, BS Yogeesha

Citation Information : Shivakumar A, Shivanandappa PD, Doddamane VP, Munish K, Yogeesha B. A Clinical Approach to the Parapharyngeal Space. Int J Head Neck Surg 2017; 8 (1):1-4.

DOI: 10.5005/jp-journals-10001-1296

Published Online: 01-03-2017

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Aim

To present the clinicopathological profile, surgical management, and the outcome of parapharyngeal space (PPS) neoplasms in 14 patients.

Materials and methods

This is a retrospective review of the clinical records of 14 patients treated for PPS tumors. The age of patients ranged from 24 to 54 years, with female to male ratio of 1.3:1. The commonest clinical presentation was a slowgrowing, painless neck swelling. The preoperative protocol was based on: (1) imaging study to establish site, size, and anatomical relationships. (2) Fine-needle aspiration cytology (FNAC) was performed to determine the nature of the mass. Details of the management, morbidity, and outcome of these patients are presented.

Results

A total of 85.7% of the PPS neoplasms were benign and 14.2% were malignant. Majority of the benign tumors were of neurogenic origin. The histocytopathology confirmed 12 (85.7%) of these diagnoses (2 patients were with “nondiagnostic” result). The positive predictive value of the FNAC was 83.3% for benign tumors and 100% for malignant tumors. In 6 patients (60%), a transcervical surgery was performed. Three patients (30%) underwent transparotid–transcervical surgery for a pleomorphic adenoma of the deep lobe of the parotid gland in the prestyloid space and transcervical–transmandibular approach was taken in 1 case (10%). Postoperative complications occurred in 3 out of 10 patients (33.3%).

Conclusion

The results of our study are in agreement with other studies reported in the literature and confirm the need to follow a careful preoperative diagnostic protocol that must take advantage of imaging studies (computed tomography, magnetic resonance imaging) and of cytology FNAC, in order to plan surgical treatment with a safe approach and that reduces complications, esthetic and functional damage, and the risk of recurrence.

How to cite this article

Shivanandappa PD, Doddamane VP, Munish KS, Yogeesha BS, Shivakumar AM. A Clinical Approach to the Parapharyngeal Space. Int J Head Neck Surg 2017;8(1):1-4.


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