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Issue N# 3 - 2012
HEAD AND NECK
Parapharyngeal tumours: Management and postoperatory results analysis
Authors : Bourget K, Joubert M, Delemazure AS, Durand N, Espitalier F, Malard O. (Nantes)
Ref. : Rev Laryngol Otol Rhinol. 2012;133,3:129-136.
Article published in french 
Downloadable PDF document french
Summary :
Objectives: Parapharyngeal space tumours are rare and mostly benign, and their access is difficult. The aim of the study was to define the optimal treatment of these tumours. Material and methods: Clinical retrospective study, with histological, treatment, prognosis analysis of the parapharyngeal space tumours occurred between 1994 and 2012 and the surgical approach considerations. Results: 35 patients were included with a male sex ratio predominance (51,43%, p= ns). The mean age of diagnosis was 49 years. The majority of tumours were benign (75,76%, p< 0,001). 54,5% originated from salivary gland with a majority of pleomorphic adenomas (42,42%). The second most frequent aetiology found was schwannoma (21,21%). 2 patients refused the treatment. Accidentally discovered were frequent (28,57%). In the symptomatic forms, dysphagia dominated (25,71%). Oropharyngeal (20%) and/or cervical (17,14%) mass were rare. A CT scan and a MR imaging were performed in 82,86% and 71,43% of the cases. A fine needle aspiration cytology was achieved in 10 cases with a positive predictive value of 60%. The cervical submandibular trans digastric approach was the most accomplished (40%). Other approaches were also used: Trans oral (25,71%), parotidectomy (14,71%), combined trans oral and cervical or parotidectomy (14,71%) and the cervical approached associated to a mandibulotomy (5,71%). A complementary treatment was proposed in 85,7% of the cases of malignant tumours. Post-operative complications were dominated by Horner’s syndrome (n= 3), a temporary facial palsy (n= 5), definitive (n= 1), a velar insufficiency (n= 1), persistent pain (n= 6). Conclusions: The presence of 25% of malignant tumours and 40% of pleomorphic adenomas require removal of parapharyngeal tumours, even if non symptomatic.
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