Endoscopy‐assisted transoral approach for parapharyngeal space tumors: Our experience and a systematic review of the literature

Abstract

Abstract Background Several approaches have been described for the excision of parapharyngeal space tumors (PPSTs). Advances in endoscopy gave a further stimulus to the use of the transoral route. Aims We present our experience with the endoscopy‐assisted transoral approach (EATA) in this regard and a review of the most recent literature about EATA for PPSTs excision. Materials and Methods We retrospectively analyzed our experience and systematically reviewed the literature about the outcomes of this technique. Results Seven PPSTs were completely excised, with three of them requiring a combined transcervical approach. Only one case of postoperative wound dehiscence was registered, and the mean length of stay was 3.9 days. Final histopathological examination confirmed the results obtained with preoperative fine‐needle aspiration biopsy in all cases and no recurrences were apparent after a mean follow‐up of 28.1 months. Discussion Magnetic resonance imaging, the modified Mallampati score and the 8 Ts criteria are useful instruments for the choice of the most appropriate surgical approach. Conclusion In light of our experience and following other published series in the literature, we believe that EATA may represent a safe and effective approach for the treatment of the majority of PPSTs.

Keywords

• endoscope‐assisted surgery
• head and neck surgery
• mini‐invasive approach
• parapharyngeal space tumors
• transoral surgery